AEGiS-15IAC: Trends in HIV related mortality: Effect of HAART.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Trends in HIV related mortality: Effect of HAART.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1159)

Gomez FA, Romero SP, Bernal JA, Gonzalez-Outon J, Briceno F, Ruiz P, Garcia-Gil D
Hospital Universitario Puerto Real, Department of Medicine, University of Cadiz, Cadiz, Spain

BACKGROUND: AIDS related mortality has decreased after the introduction of HAART. OBJECTIVE: To assess the incidence of causes of death with the improvement of HARRT.

METHODS: We studied the cause of death over three different periods pre-HAART (January 1992 to December 1994), early-HAART (January 1995 to December 1998) and post-HAART (January 1999 to October 2003), in HIV infected patients followed at our center. Results are expressed for periods pre-HAART, early HAART, and post-HAART respectively. Monthly global mortality was: 1.65%, 0.83% and 0.11%. Mean (SD) CD4/mL were: 16 5, 37 11 and 107 28 (p<0.0001). Undetectable plasma viral load (%) were: 0, 16 and 41 (p<0.0001). Patients with a prior diagnosis of AIDS were: 91%, 68% and 39% (p<0.001). The rate (%) of women/heterosexuals was: 6/2, 11/5 and 19/9 (p<0.01) and, that of IVDA (%) was: 96, 88 and 79 (p=0.03). The proportion of deaths (%) from lymphoma (1, 3 and 8 p<0.01), carcinomas (2, 7, 16 p=0.03) and liver disease (3, 9, 22 p<0.001) increased; while the proportion of deaths from suicide/overdose decreased (23, 10, 3 p<0.005). The death rate from opportunistic infections, sepsis, kaposi sarcoma, primary cerebral lymphoma, AIDS encephalopathy, progressive multifocal leukoencephalopathy or death related to ART did not significantly change.

CONCLUSIONS: AIDS related mortality has decreased after HAART. At time of death patients have higher CD4 counts, lower pVL, less advanced disease and fewer prior diagnosis of AIDS. The spectrum of mortality has changed with HAART, with more deaths due to liver disease, carcinomas and lymphomas.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Antiretroviral Therapy, Highly Active, HIV, HIV Seropositivity, CD4 Lymphocyte Count, HIV Infections, Incidence, Cause of Death, Viral Load, Anti-HIV Agents, HIV-1, Substance Abuse, Intravenous, AIDS Dementia Complex, Sarcoma, Kaposi, Leukoencephalopathy, Progressive Multifocal, Death, Sepsis, Humans, Female, mortality

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