Richard D. Moore, MD, MHS
What is the risk for death in HIV-infected persons compared with the general population? Has this risk changed since the introduction of highly active antiretroviral therapy?
Inception cohort followed for a median 6.3 years.
10 European countries, Australia, and Canada.
16 534 patients ≥ 15 years of age at HIV seroconversion (median age 29 y, 78% men) who had well-estimated dates of seroconversion (within 18 mo) and exposure to HIV through injection drug use (18% of patients), sex between men (57%), or heterosexual sex (24%).
Calendar period of follow-up (before 1996, 1996 to 1997, 1998 to 1999, 2000 to 2001, 2002 to 2003, and 2004 to 2006), sex, age at seroconversion, and HIV exposure category.
Mortality, excess mortality compared with the general uninfected population, and excess mortality in recent years compared with before 1996.
2571 HIV-infected persons died compared with 235 expected deaths in a matched general population cohort. Overall mortality was 23 per 1000 person-years (95% CI 22 to 24) and excess mortality over that of the general population was 21 per 1000 person-years (CI 20 to 22). Data by calendar period are shown in the Table. Risk for excess mortality was higher in men, persons who were older at seroconversion, and those with HIV exposure from injection drug use. In persons with sexual HIV exposure, by 2004 to 2006 mortality in the first 5 years since seroconversion did not differ from that of the general population, although mortality remained increased in persons with a longer duration of infection.
Persons infected with HIV had higher mortality than did the general population, but mortality and excess mortality have greatly decreased in the past 10 years. By 2004 to 2006, HIV seroconversion from sexual exposure was not associated with increased mortality in the first 5 years.
Mortality after HIV seroconversion at median 6.3 years
*Compared with mortality in a matched general population cohort.
†Risk for excess mortality from HIV in recent years compared with before 1996, adjusted for age at seroconversion, sex, and HIV exposure category.
Richard D. Moore. Excess mortality after HIV seroconversion has greatly decreased in the past 10 years. Ann Intern Med. 2008;149:JC5–15. doi: 10.7326/0003-4819-149-10-200811180-02015
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Published: Ann Intern Med. 2008;149(10):JC5-15.
HIV, Infectious Disease.
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