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Causes of Death in People with AIDS in New York City between 1999 and 2004 FREE

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The summary below is from the full report titled “Causes of Death among Persons with AIDS in the Era of Highly Active Antiretroviral Therapy: New York City.” It is in the 19 September 2006 issue of Annals of Internal Medicine (volume 145, pages 397-406). The authors are J.E. Sackoff, D.B. Hanna, M.R. Pfeiffer, and L.V. Torian.

Ann Intern Med. 2006;145(6):I-49. doi:10.7326/0003-4819-145-6-200609190-00002
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What is the problem and what is known about it so far?

Human immunodeficiency virus (HIV) is the cause of AIDS, an illness that interferes with the body's ability to fight infection and some types of cancer. The virus passes from person to person through contact with blood or other body fluids that contain the virus. Treatments that contain several drugs have dramatically improved health outcomes for HIV-infected patients. These treatments are known as HAART (highly active antiretroviral therapy). Before the availability and widespread use of HAART, people with AIDS usually died of an infection or cancer that was related to HIV infection. With HAART, fewer people with AIDS die of these conditions. They live longer and eventually die of causes that are unrelated to HIV infection.

Why did the authors do this particular analysis?

To describe changes in HIV-related and non–HIV-related causes of death in people with AIDS during the period when HAART became the standard of care for HIV infection.

Who was analyzed?

68,669 people with AIDS 13 years of age or older who were reported to the New York City HIV/AIDS Reporting System and Vital Statistics Registry between 1999 and 2004.

How was the analysis done?

The authors used information in the HIV/AIDS registry and on death certificates to calculate the percentage of deaths due to HIV-related and non–HIV-related causes between 1999 and 2004. They then looked for factors that were related to deaths due to an HIV-related cause and deaths due to a non–HIV-related cause.

What did the authors find?

More people with AIDS died of a non–HIV-related cause in 2004 than in 1999. More than 75% of non–HIV-related deaths were due to substance abuse, cardiovascular disease, or a non–HIV-related type of cancer. People whose risk factor for HIV infection was injection drug use had higher death rates from both HIV-related and non–HIV-related causes than people whose risk factor for HIV infection was male-to-male sexual contact.

What were the limitations of the analysis?

The analysis was based on information from death certificates, which is not as detailed as medical records, so the authors may have misclassified some causes of death.

What are the implications of the analysis?

As HIV-related causes of death decrease and non–HIV-related causes of death increase among people with AIDS, doctors and patients need to focus on the prevention and care of common illnesses, such as cardiovascular disease, substance abuse, and cancer, in addition to HIV-focused care.





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