AEGiS-14IAC: Causes of death in the era of HAART: Findings from the CHORUS observational cohort.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Causes of death in the era of HAART: Findings from the CHORUS observational cohort.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10720)

Fusco GP, Justice AC, Becker SL, Raffanti SP, Coll-Erickson P, Fusco JS
GlaxoSmithKline, RTP, United States

BACKGROUND: In an effort to better understand the impact of antiretroviral therapy on HIV-related mortality, the CHORUS cohort undertook an overhaul of the reporting of causes of death (COD). Data from the CDC showed that the five most common causes of death from 1987 to 1997 were PCP, pneumonia (recurrent), Cryptococcosis, non-TB Mycobacteriosis, and CMV disease.

METHODS: Using a one-page, structured questionnaire, AIDS defining illnesses, drug toxicities, and non-HIV comorbid conditions were captured. Deceased patients were described and compared to those prior to HAART.

RESULTS: As of January 3, 2002, 5861 patients had consented to the CHORUS cohort, 361 had died. Of these, 312 (86.4%) had had a COD form completed. Deaths occurred from 1998-2001. The ten most common causes of death in CHORUS appear below. Rank___ Cause of Death_______________________________ #patients_____ % [table: see text] CMV disease, non-TB Mycobacteriosis and Cryptococcosis were not among the ten most common causes of death. In comparison with patients still living (l) in the cohort, deceased patients (d) had higher median peak VL (d=559k / l=282k) and lower median nadir CD4 counts (d=38 / l=240) both of which were more extreme than the median values immediately before death. The majority (75.9%) of the deceased patients had been diagnosed with an AIDS-defining illness prior to death in contrast with the surviving patients (44.3%). Only 15 (4.8%) had undergone autopsy.

CONCLUSIONS: These data suggest a need for a shift in the strategic management of HIV infection toward management of comorbid conditions, toxicities and long-term immune surveillance function.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, HIV Infections, Death, Death Certificates, Tuberculosis, Prognosis, Autopsy, Mycobacterium Infections, Human, diagnosis, Mortality, etiology, EpidemiologyKWDaegis,antiretroviraltherapy,highlyactive,cd4lymphocytecount,hivinfections,death,deathcertificates,tuberculosis,prognosis,autopsy,mycobacteriuminfections,human,diagnosis,mortality,etiology,epidemiology

020707
C10720

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.