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Decreasing Excess Mortality of HIV-Infected Patients Initiating Antiretroviral Therapy
| Content Provider | Scilit |
|---|---|
| Author | Zhu, Hao Napravnik, Sonia Eron, Joseph J. Cole, Stephen R. Ma, Ye Wohl, David A. Dou, Zhihui Zhang, Yao Liu, Zhongfu Zhao, Decai Yu, Lan Liu, Xia Cohen, Myron S. Zhang, Fujie |
| Copyright Year | 2013 |
| Description | Journal: JAIDS Journal of Acquired Immune Deficiency Syndromes Objective: To evaluate excess mortality across calendar time comparing HIV-infected patients receiving combination antiretroviral therapy (cART) with the general Chinese population. Methods: Patients receiving free cART through the National Free Antiretroviral Therapy Program (NFATP) between January 1, 2003, and December 31, 2009, were included. Observed mortality rates, excess mortality rates, and standardized mortality ratios were calculated by calendar periods. Factors associated with excess mortality across calendar time were evaluated in multivariable Poisson regression models. Results: Among 64,836 HIV-infected patients, the observed and excess mortality rates in 2003–2004 were 9.5 deaths per 100 person-years [95% confidence interval (CI): 8.8 to 10.2] and 9.1 (95% CI: 8.5 to 9.8); in 2008–2009, these decreased to 5.6 (95% CI: 5.4 to 5.8) and 5.2 (95% CI: 5.0 to 5.4), respectively. The adjusted excess hazard ratio (eHR) for 2003–2004 in comparison to 2008–2009 was 1.27 (95% CI: 1.11 to 1.45). Patients initiating cART at CD4 cell counts <50 cells per microliter in comparison with ≥350 cells per microliter had an adjusted eHR of 9.92 (95% CI: 8.59 to 11.44). Patients starting cART at older ages also had greater excess mortality with an eHR of 1.63 (95% CI: 1.47 to 1.82) comparing ages ≥45 to 18–29 years. Standardized mortality ratio results were consistent with those for excess mortality. Conclusions: Substantial decreases in excess mortality were observed from 2003 to 2009 in China among HIV-infected patients receiving free cART. However, mortality among HIV-infected patients remained higher than the general Chinese population. As more efficacious first- and second-line cART regimens become increasingly available to Chinese HIV-infected patients, further reductions in overall and excess mortality are likely. |
| Related Links | http://europepmc.org/articles/pmc3752313?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752313/pdf |
| Ending Page | e157 |
| Page Count | 8 |
| Starting Page | e150 |
| ISSN | 15254135 |
| e-ISSN | 10779450 |
| DOI | 10.1097/qai.0b013e3182948d82 |
| Journal | JAIDS Journal of Acquired Immune Deficiency Syndromes |
| Issue Number | 5 |
| Volume Number | 63 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2013-08-15 |
| Access Restriction | Open |
| Subject Keyword | Journal: JAIDS Journal of Acquired Immune Deficiency Syndromes Antiretroviral Therapy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Pharmacology (medical) |
