Temporal Changes in Causes of Death Among HIV-Infected Patients in the HAART Era in Rio de Janeiro, Brazil

The widespread use of highly active antiretroviral therapy (HAART) has led to marked decreases in death rates in Brazil in HIV-infected individuals. Nonetheless, there are scarce data on specific causes of death. Death rates from a cohort of HIV-infected patients in Rio de Janeiro, Brazil, were anal...

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Bibliographic Details
Published in:	Journal of acquired immune deficiency syndromes (1999) Vol. 51; no. 5; pp. 624 - 630
Main Authors:	PACHECO, Antonio G, TUBOI, Suely H, MAY, Silvia B, MOREIRA, Luiz F. S, RAMADAS, Luciana, NUNES, Estevao P, MERCON, Mônica, FAULHABER, José C, HARRISON, Lee H, SCHECHTER, Mauro
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins 15-08-2009 Lippincott Williams & Wilkins Ovid Technologies
Subjects:	Adult AIDS-Related Opportunistic Infections - mortality Algorithms Antiretroviral drugs Antiretroviral Therapy, Highly Active Biological and medical sciences Brazil - epidemiology Cause of Death - trends Cohort Studies Developing Countries Female Fundamental and applied biological sciences. Psychology HIV HIV Infections - drug therapy HIV Infections - mortality Human immunodeficiency virus Human viral diseases Humans Infectious diseases Male Medical sciences Microbiology Middle Aged Miscellaneous Mortality Patients Proportional Hazards Models Risk factors Time Factors Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology Young Adult South America Brazil America Rio de Janeiro Brazil Immunopathology causes of death Microbiology Retroviridae AIDS Immune deficiency Lentivirus Virology Infection Virus HIV Viral disease Brazil Antiviral Human immunodeficiency virus
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Summary:	The widespread use of highly active antiretroviral therapy (HAART) has led to marked decreases in death rates in Brazil in HIV-infected individuals. Nonetheless, there are scarce data on specific causes of death. Death rates from a cohort of HIV-infected patients in Rio de Janeiro, Brazil, were analyzed in 2-year periods, from 1997 to 2006. Poisson models and survival models accounting for competing risks were used to assess association of covariables. A standardized validated algorithm was used to ascertain specific causes of death. Of the 1538 eligible patients, 226 (14.7%) died during the study period, corresponding to a mortality rate of 3.2 per 100 person-years. The median follow-up time was 4.61 years (interquartile range = 5.63 years) and the loss to follow-up rate was 2.4 per 100 person-years. Overall, 98 (43.4%) were classified as non-AIDS-related causes. Although opportunistic infections were the leading causes of death (37.6%), deaths due to AIDS-related causes declined significantly over time (P < 0.01). In the most recent period (2005-2006), the rate of non-AIDS-related causes of deaths was higher than that of AIDS-related causes of death. In the HAART era, there has been a significant change in causes of death among HIV-infected patients in Rio de Janeiro. As access to HAART improves, integration with other public programs will become critically important for the long-term success of HIV/AIDS programs in developing countries.
ISSN:	1525-4135 1944-7884
DOI:	10.1097/QAI.0b013e3181a4ecf5