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9th Annual Conference Of The British HIV Association [BHIVA]24 – 26 April 2003, University of Manchester
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[AUTHOR(S):] J Ashby1, AK Sullivan1, V Kugananthan1, C Watson1, C Mazude1, M Fisher2, M Bower1, BG Gazzard1 and MR Nelson1
1 Chelsea and Westminster Hospital, London, and 2 Royal Sussex County Hospital, Brighton, UK
BHIVA Conf 2003 Apr 24-26;9:O2
AIM: To determine the changing incidence of cause of death with improvements in highly active antiretroviral therapy (HAART).
METHODS: All deaths in three distinct time periods were recorded at two UK centres, period A (pre-HAART): May to November 1994, period B (early HAART): November 1996 to May 1998, period C June 2000 to September 2002.
RESULTS: Deaths per month: 22, 8 and 5; median CD4 count: 20, 35 and 116 cells/µl (P<000.1); viral load below detection: 0%, 8% and 39% (P<0.0001); previous AIDS: 93%, 77% and 44% (P<0001); heterosexual: 3%, 11% and 40% (P<0.0001) for periods A, B, C respectively
| n (%) | KS | Lymphoma | PCL | Other cancer | Liver disease | |
| A | 17(13) | 3(2) | 8(6) | 1(<1) | 3(2) | |
| B | 9(7) | 12(9) | 7(5) | Nil | 4(3) | |
| C | 3(2) | 13(10) | 2(2) | 14(11) | 16(12) | |
| P | 0.004 | 0.03 | 0.015 | <0.001 | 0.002 |
| n (%) | OIs | Sepsis | Suicide OD | ART related | Other | Not known | |
| A | 35(26) | 13(10) | 1(<1) | 0(0) | 20(15) | 32(24) | |
| B | 24(18) | 13(10) | 5(4) | 2(2) | 22(17) | 35(26) | |
| C | 20(15) | 24(18) | 10(8) | 4(3) | 11(8) | 14(11) | |
| P | 0.059 | 0.056 | 0.018 | 0.13 | 0.11 | 0.002 |
CONCLUSIONS: Mortality has decreased with the advent of HAART. At the time of death individuals have a higher CD4 cell count and are less likely to have had a previous AIDS diagnosis. The spectrum of causation is changing with higher rates due to AIDS-defining cancers, systemic lymphomas, and liver disease and self-harm, while the proportion of deaths from Kaposi's sarcoma (KS) and primary cerebral lymphoma (PCL) has fallen.
PRESENTING AUTHOR: J Ashby
030424
O24
Copyright © 2003 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD