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dc.contributor.authorPettit, April C
dc.contributor.authorGiganti, Mark J
dc.contributor.authorIngle, Suzanne M
dc.contributor.authorMay, Margaret T
dc.contributor.authorShepherd, Bryan E
dc.contributor.authorGill, Michael J
dc.contributor.authorFätkenheuer, Gerd
dc.contributor.authorAbgrall, Sophie
dc.contributor.authorSaag, Michael S
dc.contributor.authorAmo, Julia del 
dc.contributor.authorJustice, Amy C
dc.contributor.authorMiro, Jose M
dc.contributor.authorCavasinni, Matthias
dc.contributor.authorDabis, François
dc.contributor.authorMonforte, Antonella D
dc.contributor.authorReiss, Peter
dc.contributor.authorGuest, Jodie
dc.contributor.authorMoore, David
dc.contributor.authorShepherd, Leah
dc.contributor.authorObel, Niels
dc.contributor.authorCrane, Heidi M
dc.contributor.authorSmith, Colette
dc.contributor.authorTeira, Ramon
dc.contributor.authorZangerle, Robert
dc.contributor.authorSterne, Jonathan Ac
dc.contributor.authorSterling, Timothy R
dc.date.accessioned2018-02-21T12:03:28Z
dc.date.available2018-02-21T12:03:28Z
dc.date.issued2018-01
dc.identifier.citationJ Int AIDS Soc. 2018; 21(1): e25031es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/5598
dc.description.abstractINTRODUCTION: HIV-1 infection leads to chronic inflammation and to an increased risk of non-AIDS mortality. Our objective was to determine whether AIDS-defining events (ADEs) were associated with increased overall and cause-specific non-AIDS related mortality after antiretroviral therapy (ART) initiation. METHODS: We included HIV treatment-naïve adults from the Antiretroviral Therapy Cohort Collaboration (ART-CC) who initiated ART from 1996 to 2014. Causes of death were assigned using the Coding Causes of Death in HIV (CoDe) protocol. The adjusted hazard ratio (aHR) for overall and cause-specific non-AIDS mortality among those with an ADE (all ADEs, tuberculosis (TB), Pneumocystis jiroveci pneumonia (PJP), and non-Hodgkin's lymphoma (NHL)) compared to those without an ADE was estimated using a marginal structural model. RESULTS: The adjusted hazard of overall non-AIDS mortality was higher among those with any ADE compared to those without any ADE (aHR 2.21, 95% confidence interval (CI) 2.00 to 2.43). The adjusted hazard of each of the cause-specific non-AIDS related deaths were higher among those with any ADE compared to those without, except metabolic deaths (malignancy aHR 2.59 (95% CI 2.13 to 3.14), accident/suicide/overdose aHR 1.37 (95% CI 1.05 to 1.79), cardiovascular aHR 1.95 (95% CI 1.54 to 2.48), infection aHR (95% CI 1.68 to 2.81), hepatic aHR 2.09 (95% CI 1.61 to 2.72), respiratory aHR 4.28 (95% CI 2.67 to 6.88), renal aHR 5.81 (95% CI 2.69 to 12.56) and central nervous aHR 1.53 (95% CI 1.18 to 5.44)). The risk of overall and cause-specific non-AIDS mortality differed depending on the specific ADE of interest (TB, PJP, NHL). CONCLUSIONS: In this large multi-centre cohort collaboration with standardized assignment of causes of death, non-AIDS mortality was twice as high among patients with an ADE compared to without an ADE. However, non-AIDS related mortality after an ADE depended on the ADE of interest. Although there may be unmeasured confounders, these findings suggest that a common pathway may be independently driving both ADEs and NADE mortality. While prevention of ADEs may reduce subsequent death due to NADEs following ART initiation, modification of risk factors for NADE mortality remains important after ADE survival.es_ES
dc.description.sponsorshipWe would like to thank the following cohorts for participating in this study; the AIDS Therapy Evaluation Project Netherlands (ATHENA); ANRS CO4 French Hospital Database on HIV (FHDH); ANRS CO3 Aquitaine Cohort, France; Departments of Internal Medicine at University of Cologne and Bonn, Germany; K€oln/Bonn Cohort, Germany; Italian Cohort of Antiretroviral-Na€ıve Patients (ICONA); CORIS, Spain; Proyecto para la Informatizaci on del Seguimiento Cl ınico-epidemiol ogico de la Infecci on por HIV y SIDA (PISCIS), Spain; Royal Free Hospital Cohort, London UK; Swiss HIV Cohort Study (SHCS); The Multicenter Study Group on EuroSIDA; Southern Alberta Clinic, Canada; HIV Atlanta Veterans affairs Cohort Study (HAVACS), USA; UAB 1917 Clinic Cohort, Birmingham, Alabama, USA; Veterans Ageing Cohort Study (VACS8),USA; Vanderbilt- Meharry and Tennessee Center for AIDS Research, Nashville, Tennessee, USA; University of Washington Harborview Medical Center, USA; € Osterreichische HIV-Kohortenstudie (OEHIVKOS), Austria; Danish HIV Cohort Study, Denmark; VACH, (Spain); and HAART Observational Medical Evaluation and Research (HOMER), British Columbia, Canada. We would also like to thank the ART-CC Steering group.es_ES
dc.language.isoenges_ES
dc.publisherWiley es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAIDS-defining eventses_ES
dc.subjectPneumocystis jiroveci pneumoniaes_ES
dc.subjectMarginal structural modeles_ES
dc.subjectNon-AIDS mortalityes_ES
dc.subjectNon-Hodgkin's lymphomaes_ES
dc.subjectTuberculosises_ES
dc.titleIncreased non-AIDS mortality among persons with AIDS-defining events after antiretroviral therapy initiationes_ES
dc.typejournal articlees_ES
dc.rights.licenseAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.identifier.pubmedID29334197es_ES
dc.format.volume21es_ES
dc.format.number1es_ES
dc.format.pagee25031es_ES
dc.identifier.doi10.1002/jia2.25031es_ES
dc.contributor.funderMedical Research Council (Reino Unido) 
dc.contributor.funderDepartment for International Development (Reino Unido) 
dc.contributor.funderNational Institutes of Health (Estados Unidos) 
dc.contributor.funderVanderbilt University Medical Center (Estados Unidos) 
dc.contributor.funderMinisterio de Sanidad y Consumo (España) 
dc.contributor.funderInstituto de Salud Carlos III 
dc.contributor.funderRed de Investigación Cooperativa en Investigación en Sida (España) 
dc.contributor.funderAgence Nationale de Recherches sur le sida et les hépatites virales (Francia) 
dc.contributor.funderStichting HIV Monitoring (Netherlands) 
dc.contributor.funderAugustinus Foundation
dc.description.peerreviewedes_ES
dc.identifier.e-issn1758-2652es_ES
dc.identifier.journalJournal of the International AIDS Societyes_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.repisalud.institucionISCIIIes_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7/260694/EUes_ES
dc.rights.accessRightsopen accesses_ES


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Attribution-NonCommercial-NoDerivatives 4.0 Internacional
Este Item está sujeto a una licencia Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 Internacional