2026-04-29T01:00:06Zhttps://repisalud.isciii.es/rest/oai/request
oai:repisalud.isciii.es:20.500.12105/254352025-12-18T13:01:29Zcom_20.500.12105_2052com_20.500.12105_2051col_20.500.12105_19608
Repisalud author Trickey, Adam author Zhang, Lei author Rentsch, Christopher T author Pantazis, Nikos author Izquierdo Miguel, Rebeca author Antinori, Andrea author Leierer, Gisela author Burkholder, Greer author Cavassini, Matthias author Palacio-Vieira, Jorge author Gill, M John author Teira, Ramon author Stephan, Christoph author Obel, Niels author Vehreschild, Jörg-Janne author Sterling, Timothy R author van der Valk, Marc author Bonnet, Fabrice author Crane, Heidi M author Silverberg, Michael J author Ingle, Suzanne M author Sterne, Jonathan A C author Antiretroviral Therapy Cohort Collaboration (ART-CC) funder NIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos) funder National Institute for Health Research (Reino Unido) funder Wellcome Trust funder Gilead Sciences (Spain) funder Agence Nationale de Recherches sur le sida et les hépatites virales (Francia) funder Ministère de la Santé (Francia) funder Austrian Agency for Health and Food Safety funder Stichting HIV Monitoring funder Ministry of Health (Holanda) funder National Institute for Public Health and the Environment (Holanda) funder German Center for Infection Research (Alemania) funder RETICS-Sida (RIS-ISCIII) (España) funder Plan Nacional de I+D+i (España) funder Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) funder ViiV Healthcare funder Preben og Anna Simonsens Fond funder Institut National de la Santé et de la Recherche Médicale (Francia) funder Bristol-Myers Squibb funder Janssen Cilag funder Ministerio de Sanidad (España) funder CFAR Network of Integrated Clinical Systems (CNICS) funder Swiss National Science Foundation funder United States Department of Veterans Affairs funder NIH - National Institute of Allergy and Infectious Diseases (NIAID) (Estados Unidos) 2024-11-05T12:27:03Z 2024-11-05T12:27:03Z 2024-08-01 AIDS 2024 Aug 1;38(10):1533-1542. 0269-9370 https://hdl.handle.net/20.500.12105/25435 38742863 10.1097/QAD.0000000000003924 1473-5571 AIDS (London, England) Objective: Interruptions in care of people with HIV (PWH) on antiretroviral therapy (ART) are associated with adverse outcomes, but most studies have relied on composite outcomes. We investigated whether mortality risk following care interruptions differed from mortality risk after first starting ART. Design: Collaboration of 18 European and North American HIV observational cohort studies of adults with HIV starting ART between 2004 and 2019. Methods: Care interruptions were defined as gaps in contact of ≥365 days, with a subsequent return to care (distinct from loss to follow-up), or ≥270 days and ≥545 days in sensitivity analyses. Follow-up time was allocated to no/preinterruption or postinterruption follow-up groups. We used Cox regression to compare hazards of mortality between care interruption groups, adjusting for time-updated demographic and clinical characteristics and biomarkers upon ART initiation or re-initiation of care. Results: Of 89 197 PWH, 83.4% were male and median age at ART start was 39 years [interquartile range (IQR): 31-48)]. 8654 PWH (9.7%) had ≥1 care interruption; 10 913 episodes of follow-up following a care interruption were included. There were 6104 deaths in 536 334 person-years, a crude mortality rate of 11.4 [95% confidence interval (CI): 11.1-11.7] per 1000 person-years. The adjusted mortality hazard ratio (HR) for the postinterruption group was 1.72 (95% CI: 1.57-1.88) compared with the no/preinterruption group. Results were robust to sensitivity analyses assuming ≥270-day (HR 1.49, 95% CI: 1.40-1.60) and ≥545-day (HR 1.67, 95% CI: 1.48-1.88) interruptions. Conclusions: Mortality was higher among PWH reinitiating care following an interruption, compared with when PWH initially start ART, indicating the importance of uninterrupted care. eng Adherence Antiretroviral therapy Mortality North America Treatment gap Western Europe Care interruptions and mortality among adults in Europe and North America research article 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 URL https://repisalud.isciii.es/bitstreams/e24a5789-a0a0-4fed-8f9f-2a1eea14d1e7/download File MD5 7ac203293655eb6366d71dfdadd84e1a 369388 application/pdf CareInterruptionsMortalityAmong_2024.pdf URL https://repisalud.isciii.es/bitstreams/a8c87787-f937-4eef-8b81-0db7d7f92345/download File MD5 f092dbc7acf8974c175780ad40a21e1e 539403 application/pdf Supplementary1_CareInterruptionsMortalityAmong_2024.pdf URL https://repisalud.isciii.es/bitstreams/7bbd4d96-1743-4dd4-ba19-611ea3b0a26e/download File MD5 412672af4ba4570aabf83d3a56474fef 112634 application/pdf Supplementary2_CareInterruptionsMortalityAmong_2024.pdf