Cause of death among HIV patients in London in 2016

Croxford, Sara; Miller, R F; Post, Frank A.; Harding, Richard; Lucas, Sebastian; Figueroa, José Natal; Harrison, Ian; Delpech, Valérie; Dhoot, S.; Sullivan, Ann

doi:10.1111/hiv.12761

Cited by 13 publications

(10 citation statements)

References 14 publications

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“…The spectrum of causes of hospitalisation in our study are similar to those found for mortality in PLHIV in recent studies in high income settings [13][14][15], including a study of 206 deaths of PLHIV in London in 2016, suggesting a similar underlying pattern of morbidity not dominated by AIDS-defining illnesses [13].…”

Section: Discussionsupporting

confidence: 87%

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Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

et al. 2021

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Background We describe the spectrum of ICD-10 classified causes for hospitalisations occurring between 2011 and 2018 in a cohort of people living with HIV (PLHIV). Methods This sub-study includes 798 PLHIV participating in the Antiretroviral, Sexual Transmission Risk and Attitudes (ASTRA) questionnaire study who were recruited from a large London centre. A medical record review identified the occurrence and causes of hospitalisation from the date of questionnaire completion (February–December 2011) until 1 June 2018. Up to five causes were classified by an HIV clinician using the ICD-10 system. Results There were 274 hospitalisations in 153 people (rate = 5.8/100 person-years; 95% CI: 5.1, 6.5). Causes were wide-ranging; the most common were circulatory (16.8%), digestive (13.1%), respiratory (11.7%), infectious diseases (11.0%), injury/poisoning (10.6%), genitourinary diseases (9.9%) and neoplasms (9.1%). A tenth (27/274) of hospitalisations were related to at least one AIDS-defining illness. Median duration of hospitalisation was 5 days (IQR 2–9). At the time of hospitalisation, median CD4 count was high (510 cells/μl; IQR: 315–739), while median CD4 nadir was relatively low (113 cells/μl; IQR: 40–239). At admission, half of individuals (51%) had a previous AIDS-defining illness and 21% had viral load > 50 copies/ml. Individuals admitted for infectious diseases were particularly likely to have unfavourable HIV-related clinical characteristics (low CD4, viral non-suppression, not on antiretroviral therapy (ART), previous AIDS). Conclusions In the modern combination antiretroviral therapy era, the spectrum of causes of hospitalisation in PLHIV in the UK is wide-ranging, highlighting the importance of holistic care for PLHIV, including prevention, early detection and treatment of comorbidities.

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Section: Discussionsupporting

confidence: 87%

“…For ADI hospitalisations, the median (IQR) current and nadir CD4 counts at admission were 560 (339-700) and 69 (17-202) cells/μl respectively, 26 (96%) were on ART and 11 (41%) had viral load> 50 copies/ml. The median time since HIV diagnosis was 20 years (IQR: [13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: Resultsmentioning

confidence: 99%

Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

et al. 2021

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“…The comorbidities commonly reported among people with HIV who died of/with COVID-19 in England included CVD (69%), obesity (49%), diabetes mellitus (48%), CKD (41%) and hypertension (39%). These rates are higher than those reported among all people living with diagnosed HIV (Table S2) [3,26], higher than those documented among people with HIV who died pre-COVID-19 and higher than the general population as a whole [27,28]. These findings are consistent with the literature and highlight the importance of ensuring optimal care of comorbidities alongside HIV care [29][30][31][32].…”

Section: Discussionsupporting

confidence: 85%

COVID‐19 mortality among people with diagnosed HIV compared to those without during the first wave of the COVID‐19 pandemic in England

et al. 2021

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Objectives We describe COVID‐19 mortality among people with and without HIV during the first wave of the pandemic in England. Methods National surveillance data on adults (aged ≥ 15 years) with diagnosed HIV resident in England were linked to national COVID‐19 mortality surveillance data (2 March 2020–16 June 2020); HIV clinicians verified linked cases and provided information on the circumstances of death. We present COVID‐19 mortality rates by HIV status, using negative binomial regression to assess the association between HIV and mortality, adjusting for gender, age and ethnicity. Results Overall, 99 people with HIV, including 61 of black ethnicity, died of/with COVID‐19 (107/100 000) compared with 49 483 people without HIV (109/100 000). Compared to people without HIV, higher COVID‐19 mortality rates were observed in people with HIV of black (188 vs. 122/100 000) and Asian (131 vs. 77.0/100 000) ethnicity, and in both younger (15–59 years: 58.3 vs. 10.2/100 000) and older (≥ 60 years: 434 vs. 355/100 000) people. After adjustment for demographic factors, people with HIV had a higher COVID‐19 mortality risk than those without (2.18; 95% CI: 1.76–2.70). Most people with HIV who died of/with COVID‐19 had suppressed HIV viraemia (91%) and at least one comorbidity reported to be associated with poor COVID‐19 outcomes (87%). Conclusions In the first wave of the pandemic in England, COVID‐19 mortality among people with HIV was low, but was higher than in those without HIV, after controlling for demographic factors. This supports the strategy of prioritizing COVID‐19 vaccination for people with HIV and strongly encouraging its uptake, especially in those of black and Asian ethnicity.

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“…The spectrum of causes of hospitalisation in our study are similar to those found for mortality in PLHIV in recent studies in high income settings, [13][14][15] including a study of 206 deaths of PLHIV in London in 2016, suggesting a similar underlying pattern of morbidity not dominated by AIDS-de ning illnesses 13 .…”

Section: Discussionsupporting

confidence: 86%

Causes of Hospitalisation Over 2011-2018 Among a Cohort of People With HIV From a London Centre

Rein¹,

Lampe²,

Chaloner³

et al. 2020

Preprint

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Objective: To describe the spectrum of ICD-10 classified causes for hospitalisations occurring between 2011/2012 and 2018 in a cohort of PLHIV.Methods: This sub-study includes 798 HIV-positive individuals participating in the Antiretroviral, Sexual Transmission Risk and Attitudes (ASTRA) questionnaire study who were recruited from a large London centre. A medical record review identified the occurrence and causes of hospitalisation from the date of questionnaire completion (2011-2012) until 1 June 2018. Up to five causes were classified by an HIV clinician using the ICD-10 system.Results: There were 274 hospitalisations in 153 people (rate=5.8/100 person-years; 95% CI: 5.1, 6.5). Causes were wide-ranging; the most common were circulatory (16.8%), digestive (13.1%), respiratory (11.7%), infectious diseases (11.0%), injury/poisoning (10.6%), genitourinary diseases (9.9%) and neoplasms (9.1%). A tenth (27/274) of hospitalisations were related to at least one AIDS-defining illness. Median duration of hospitalisation was 5 days. At the time of hospitalisation, median CD4 count was high (510 cells/µl; IQR: 315-739), while median CD4 nadir was relatively low (113 cells/µl; IQR: 40-239). At admission, half of individuals (51%) had a previous AIDS-defining illness and 21% had viral load >50 copies/ml. Individuals admitted for infectious diseases were particularly likely to have unfavourable clinical characteristics (low CD4, viral non-suppression, not on ART, previous AIDS).Conclusions: In the modern cART era, the spectrum of causes of hospitalisation in PLHIV in the UK is wide-ranging, highlighting the importance of holistic care for PLHIV, including prevention, early detection and treatment of comorbidities.

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Cause of death among HIV patients in London in 2016

Cited by 13 publications

References 14 publications

Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

COVID‐19 mortality among people with diagnosed HIV compared to those without during the first wave of the COVID‐19 pandemic in England

Causes of Hospitalisation Over 2011-2018 Among a Cohort of People With HIV From a London Centre

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Cause of death among HIV patients in London in 2016

Cited by 13 publications

References 14 publications

Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

COVID‐19 mortality among people with diagnosed HIV compared to those without during the first wave of the COVID‐19 pandemic in England

Causes of Hospitalisation Over 2011-2018 Among a Cohort of People With HIV&nbsp;From a London Centre

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Causes of Hospitalisation Over 2011-2018 Among a Cohort of People With HIV From a London Centre