Comparisons of causes of death and mortality rates among HIV-infected persons: Analysis of the pre-, early, and late HAART (Highly Active Antiretroviral Therapy) eras

Nancy F. Crum*, Robert H. Riffenburgh, Scott Wegner, Brian K. Agan, Sybil A. Tasker, Katherine M. Spooner, Adam W. Armstrong, Susan Fraser, Mark R. Wallace

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

400 Scopus citations

Abstract

Methods: Comparisons of death-related variables during the 3 eras were performed. Results: The number of deaths declined over the study period, with 987 deaths in the pre-HAART era, 159 deaths in the early HAART era (1997-1999), and 78 deaths in the late HAART era (2000-2003) (P < 0.01). The annual death rate peaked in 1995 (10.3 per 100 patients) and then declined to <2 deaths per 100 persons in the late HAART era (P < 0.01). The proportion of deaths attributable to infection decreased, but infection remained the leading cause of death in our cohort, followed by cancer. Of those who died, there was an increasing proportion of non-HIV-related deaths (32% vs. 9%; P < 0.01), including cardiac disease (22% vs. 8%; P < 0.01) and trauma (8% vs. 2%; P = 0.01) in the post-HAART versus pre-HAART era. Despite the absence of intravenous drug use and the low prevalence of hepatitis C coinfection in our cohort, an increasing proportion of deaths in the HAART era were attributable to liver disease, although the numbers are small. Conclusions: Despite increasing concerns regarding antiretroviral resistance, the death rate among HIV-infected persons in our cohort continues to decline. Our data show a lower death rate than that reported among many other US HIV-infected populations; this may be the result of open access to health care. A shift in the causes of death toward non-HIV-related causes suggests that a more comprehensive health care approach may be needed for optimal life expectancy; this may include enhanced screening for malignancy and heart disease as well as preventive measures for liver disease and accidents.

Original languageEnglish
Pages (from-to)194-200
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume41
Issue number2
DOIs
StatePublished - Feb 2006

Keywords

  • AIDS
  • Cause of death
  • HIV
  • Mortality
  • Survival

Fingerprint

Dive into the research topics of 'Comparisons of causes of death and mortality rates among HIV-infected persons: Analysis of the pre-, early, and late HAART (Highly Active Antiretroviral Therapy) eras'. Together they form a unique fingerprint.

Cite this