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  • AIDS-related and non-AIDS-related mortality in the Asia-Pacific region in the era of combination antiretroviral treatment

    Author(s)
    Falster, Kathleen
    Choi, Jun Yong
    Donovan, Basil
    Duncombe, Chris
    Mulhall, Brian
    Sowden, David
    Zhou, Jialun
    Law, Matthew G.
    Chuah, John
    et al.
    Griffith University Author(s)
    Chuah, John
    Year published
    2009
    Metadata
    Show full item record
    Abstract
    Objective: Although studies have shown reductions in mortality from AIDS after the introduction of combination antiretroviral treatment (cART), little is known about cause-specific mortality in low-income settings in the cART era. We explored predictors of AIDS and non-AIDS mortality and compared cause-specific mortality across high-income and low-income settings in the Asia-Pacific region. Methods: We followed patients in the Asia Pacific HIV Observational Database from the date they started cART (or cohort enrolment if cART initiation was identified retrospectively), until the date of death or last follow-up visit. ...
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    Objective: Although studies have shown reductions in mortality from AIDS after the introduction of combination antiretroviral treatment (cART), little is known about cause-specific mortality in low-income settings in the cART era. We explored predictors of AIDS and non-AIDS mortality and compared cause-specific mortality across high-income and low-income settings in the Asia-Pacific region. Methods: We followed patients in the Asia Pacific HIV Observational Database from the date they started cART (or cohort enrolment if cART initiation was identified retrospectively), until the date of death or last follow-up visit. Competing risks methods were used to estimate the cumulative incidence, and to investigate predictors, of AIDS and non-AIDS mortality. Results: Of 4252 patients, 215 died; 89 from AIDS, 97 from non-AIDS causes and 29 from unknown causes. Age more than 50 years [hazard ratio 4.29; 95% confidence interval (CI) 2.10-8.79] and CD4 cell counts less than or equal to 100 cells/嬠(hazard ratio 8.59; 95% CI 5.66-13.03) were associated with an increased risk of non-AIDS mortality. Risk factors for AIDS mortality included CD4 cell counts less than or equal to 100 cells/嬠(hazard ratio 34.97; 95% CI 18.01-67.90) and HIV RNA 10 001 or more (hazard ratio 4.21; 95% CI 2.07-8.55). There was some indication of a lower risk of non-AIDS mortality in Asian high-income, and possibly low-income, countries compared to Australia. Conclusion: Immune deficiency is associated with an increased risk of AIDS and non-AIDS mortality. Older age predicts non-AIDS mortality in the cART era. Less conclusive was the association between country-income level and cause-specific mortality because of the relatively high proportion of unknown causes of death in low-income settings.
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    Journal Title
    AIDS
    Volume
    23
    Issue
    17
    Publisher URI
    https://journals.lww.com/aidsonline/Fulltext/2009/11130/AIDS_related_and_non_AIDS_related_mortality_in_the.10.aspx
    DOI
    https://doi.org/10.1097/QAD.0b013e328331910c
    Subject
    Medical and Health Sciences not elsewhere classified
    Biological Sciences
    Medical and Health Sciences
    Psychology and Cognitive Sciences
    Publication URI
    http://hdl.handle.net/10072/29783
    Collection
    • Journal articles

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