Trends in Mortality in People With Human Immunodeficiency Virus From 1999 through 2020: A Multicohort Collaboration
Author:
Tusch Erich1ORCID, Ryom Lene123, Pelchen-Matthews Annegret4, Mocroft Amanda14, Elbirt Daniel5, Oprea Cristiana6, Günthard Huldrych F78, Staehelin Cornelia9, Zangerle Robert10, Suarez Isabelle11, Vehreschild Jörg Janne11, Wit Ferdinand12, Menozzi Marianna13, d’Arminio Monforte Antonella14, Spagnuolo Vincenzo15, Pradier Christian16, Carlander Christina17, Suanzes Paula18, Wasmuth Jan-Christian19, Carr Andrew20, Petoumenos Kathy21, Borgans Frauke22, Bonnet Fabrice23, De Wit Stephane24, El-Sadr Wafaa25, Neesgaard Bastian1, Jaschinski Nadine1, Greenberg Lauren1, Hosein Sean R26, Gallant Joel27, Vannappagari Vani28, Young Lital29, Sabin Caroline4, Lundgren Jens1, Peters Lars1, Reekie Joanne1, , El-Sadr W, Calvo G, Bonnet F, Dabis F, Kirk O, Mocroft A, Law M, d’Arminio Monforte A, Morfeldt L, Pradier C, Reiss P, Weber R, De Wit S, Lind-Thomsen A, Brandt R Salbøl, Hillebreght M, Zaheri S, Wit F W N M, Scherrer A, Schöni-Affolter F, Rickenbach M, Tavelli A, Fanti I, Leleux O, Mourali J, Marec F Le, Boerg E, Thulin E, Sundström A, Bartsch G, Thompsen G, Necsoi C, Delforge M, Fontas E, Caissotti C, Dollet K, Mateu S, Torres F, Petoumenos K, Blance A, Huang R, Puhr R, Laut K Grønborg, Kristensen D, Sabin C A, Phillips A N, Kamara D A, Smith C J, Mocroft A, Hatleberg C I, Lind-Thomsen A, Brandt R S, Raben D, Matthews C, Bojesen A, Grevsen A L, Lundgren J D, Ryom L, Powderly B, Shortman N, Moecklinghoff C, Reilly G, Franquet X, Ryom L, Mocroft A, Kirk O, Reiss P, Smit C, Ross M, Fux C A, Morlat P, Fontas E, Kamara D A, Smith C J, Lundgren J D, Smith C J, Ryom L, Hatleberg C I, Phillips A N, Weber R, Morlat P, Pradier C, Reiss P, Wit F W N M, Friis-Møller N, Kowalska J, Lundgren J D, Sabin C A, Ryom L, Hatleberg C I, Law M, d’Arminio Monforte A, Dabis F, Bonnet F, Reiss P, Wit F W N M, Smith C J, Kamara D A, Bohlius J, Bower M, Fätkenheuer G, Grulich A, Lundgren J D, Sjøl A, Meidahl P, Iversen J S, Reiss Central P, Zaheri S, Hillebregt M, Wit F W N M, Prins J M, Kuijpers T W, Scherpbier H J, van der Meer J T M, Wit F W N M, Godfried M H, Reiss P, van der Poll T, Nellen F J B, Geerlings S E, van Vugt M, Pajkrt D, Bos J C, Wiersinga W J, van der Valk M, Goorhuis A, Hovius J W, van Eden J, Henderiks A, van Hes A M H, Mutschelknauss M, Nobel H E, Pijnappel F J J, Jurriaans S, Back N K T, Zaaijer H L, Berkhout B, Cornelissen M T E, Schinkel C J, Thomas X V, De Ruyter Ziekenhuis Admiraal, van den Berge M, Stegeman A, Baas S, de Looff L Hage, Versteeg D, Ziekenhuis Catharina, Pronk M J H, Ammerlaan H S M, De Munnik E S, Jansz A R, Tjhie J, Wegdam M C A, Deiman B, Scharnhorst V, van der Plas A, Weijsenfeld A M, van der Ende M E, De Vries-Sluijs T E M S, van Gorp E C M, Schurink C A M, Nouwen J L, Verbon A, Rijnders B J A, Bax H I, van der Feltz M, Bassant N, van Beek J E A, Vriesde M, van Zonneveld L M, de Oude-Lubbers A, van den Berg-Cameron H J, Bruinsma-Broekman F B, de Groot J, de Man M de Zeeuw-, Boucher C A B, Koopmans M P G, van Kampen J J A, Pas S D, MC–Sophia Erasmus, Driessen G J A, van Rossum A M C, van der Knaap L C, Visser E, Branger J, Rijkeboer-Mes A, de Ven C J H M Duijf-van, Ziekenhuis Haga, Schippers E F, van Nieuwkoop C, van IJperen J M, Geilings J, van der Hut G, Franck P F H, van Eeden A, Brokking W, Groot M, Elsenburg L J M, Damen M, Kwa I S, Groeneveld P H P, Bouwhuis J W, van den Berg J F, van Hulzen A G W, van der Bliek G L, Bor P C J, Bloembergen P, Wolfhagen M J H M, Ruijs G J H M, Kroon F P, de Boer M G J, Bauer M P, Jolink H, Vollaard A M, Dorama W, van Holten N, Claas E C J, Wessels E, den Hollander J G, Pogany K, Roukens A, Kastelijns M, Smit J V, Smit E, Struik-Kalkman D, Tearno C, Bezemer M, van Niekerk T, Pontesilli O, Lowe S H, Lashof A M L Oude, Posthouwer D, Ackens R P, Schippers J, Vergoossen R, Weijenberg-Maes B, van Loo I H M, Havenith T R A, Leyten E M S, Gelinck L B S, van Hartingsveld A, Meerkerk C, Wildenbeest G S, Mutsaers J A E M, Jansen C L, Mulder J W, Vrouenraets S M E, Lauw F N, van 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Affiliation:
1. Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen , Copenhagen , Denmark 2. Department of Infectious Diseases, Hvidovre University Hospital , Copenhagen , Denmark 3. Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark 4. Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, University College London , London , United Kingdom 5. Allergy, Immunology and HIV Unit, Kaplan Medical Center , Rehovot , Israel 6. HIV department, Victor Babes Clinical Hospital for Infectious and Tropical Diseases , Bucharest , Romania 7. Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich , Zurich , Switzerland 8. Institute of Medical Virology, University of Zurich , Zurich , Switzerland 9. Department of Infectious Diseases, Bern University Hospital, University of Bern , Bern , Switzerland 10. Austrian HIV Cohort Study (AHIVCOS), Medizinische Universität Innsbruck , Innsbruck , Austria 11. Department I for Internal Medicine, University Hospital Cologne , Cologne , Germany 12. AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, HIV Monitoring Foundation , Amsterdam , The Netherlands 13. Modena HIV Cohort, Università degli Studi di Modena , Modena , Italy 14. Italian Cohort Naive Antiretrovirals (ICONA), ASST Santi Paolo e Carlo , Milano , Italy 15. Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute , Milano , Italy 16. Nice HIV Cohort, Université Côte d’Azur et Centre Hospitalier Universitaire , Nice , France 17. Swedish InfCare HIV Cohort, Karolinska University Hospital , Stockholm , Sweden 18. Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus , Barcelona , Spain 19. Infectious Diseases/HIV Department of the Medical Clinic I, University Hospital Bonn , Bonn , Germany 20. HIV and Immunology Unit, St Vincent's Hospital , Sydney, New South Wales , Australia 21. Australian HIV Observational Database (AHOD), UNSW , Sydney, New South Wales , Australia 22. Department of Internal Medicine, Infectious Diseases, Frankfurt HIV Cohort Study, Goethe-University Hospital, University Hospital , Frankfurt , Germany 23. Bordeaux Population Health Centre & CHU de Bordeaux, University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Saint-André Hospital, Service de Médecine Interne et Maladies Infectieuses , Bordeaux, Cedex , France 24. Department of Infectious Diseases, St Pierre University Hospital , Brussels , Belgium 25. Mailman School of Public Health, Columbia University , New York, New York , USA 26. European AIDS Treatment Group (EATG) , Brussels , Belgium 27. Gilead Sciences , Foster City, California , USA 28. ViiV Healthcare, Research Triangle Park , North Carolina , USA 29. Merck Sharp & Dohme , Rahway, New Jersey , USA
Abstract
Abstract
Background
Mortality among people with human immunodeficiency virus (HIV) declined with the introduction of combination antiretroviral therapy. We investigated trends in mortality in people with HIV from 1999 through 2020.
Methods
Data were collected from the Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) cohort between January 1999 through January 2015 and the International Cohort Consortium of Infectious Disease (RESPOND) from October 2017 through December 2020. Age-standardized all-cause and cause-specific mortality rates, classified using Coding Causes of Death in HIV, were calculated. Poisson models were used to assess mortality over time.
Results
Among 55 716 participants followed for median 6 years (interquartile range, 3–11), 5263 died (mortality rate [MR], 13.7/1000 person-years of follow-up [PYFU]; 95% confidence interval [CI], 13.4–14.1). Changing mortality was observed: AIDS mortality was most common between 1999–2009 (n = 952; MR, 4.2/1000 PYFU; 95% CI, 4.0–4.5) and non-AIDS–defining malignancy (NADM) between 2010–2020 (n = 444; MR, 2.8/1000 PYFU; 95% CI, 2.5–3.1). In multivariable analysis, all-cause mortality declined (adjusted mortality rate ratio [aMRR], 0.97 per year; 95% CI, .96–.98), mostly 1999–2010 (aMRR, 0.96 per year; 95% CI, .95–.97) but was stable 2011–2020 (aMRR, 1.00 per year; 95% CI, .96–1.05). Mortality due to all known causes except NADM also declined.
Conclusions
Mortality among people with HIV in the D:A:D and/or RESPOND cohorts declined between 1999–2009 and was stable over the period 2010–2020. This decline in mortality was not fully explained by improvements in immunologic–virologic status or other risk factors.
Funder
Community Programs for Clinical Research on AIDS Barcelona Antiretroviral Surveillance Study
Publisher
Oxford University Press (OUP)
Cited by
2 articles.
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