Differences in the causes of death of HIV-positive patients in a cohort study by data sources and coding algorithms

Hernando, Victoria; Sobrino-Vegas, Paz; Burriel, M. Carmen; Berenguer, Juan; Navarro, Gemma; Santos, Ignacio; Repáraz, Jesús; Martínez, Mònica; Antela, Antonio; Gutiérrez, Félix; Amo, Julia del; cohort, CoRIS

doi:10.1097/qad.0b013e328352ada4

Cited by 29 publications

(33 citation statements)

References 8 publications

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“…This is an important asset of this study as the majority of previous studies have coded deaths in cohort members using algorithms different from those used for denominators. Concordance between different death coding algorithms has been insufficiently studied [23]. With respect to subjects excluded from the analysis, we believe that they do not introduce important biases.…”

Section: Discussionmentioning

confidence: 97%

“…In Spain, despite the continuous decrease of HCV coinfection due to declines in the proportion of injecting drug users (IDUs), HCV prevalence in HIV positive subjects remains high, and mortality due to liver diseases in HIV populations partly replaces mortality from AIDS prior to cART [18][19][20][21]. Liver-related deaths were the second commonest cause of death in CoRIS, the Cohort of the Spanish Research Network on AIDS, accounting for 10% of all events [22,23].…”

Section: Introductionmentioning

confidence: 99%

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All-cause and liver-related mortality in HIV positive subjects compared to the general population: Differences by HCV co-infection

Hernando

Cachafeiro

Lewden

et al. 2012

Journal of Hepatology

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107

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

All-cause and liver-related mortality in HIV positive subjects compared to the general population: Differences by HCV co-infection

Hernando

Cachafeiro

Lewden

et al. 2012

Journal of Hepatology

Self Cite

107

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“…As expected, the estimated absolute risks of non-AIDS mortality were higher in the sensitivity analysis assuming that all deaths for unknown cause were non-AIDS deaths, although risk differences and risk ratios were similar. Moreover, it has been shown that the ICD10 classification for cause of death in individuals known to be HIV-positive tends to misclassify liver disease-related mortality into AIDS-related mortality 33. Finally, the cohorts included in the HIV-CAUSAL Collaboration are not based on random samples of the HIV population, tend to include many HIV seroconverters and might therefore not be fully representative of HIV patients in care in high-income countries.…”

Section: Discussionmentioning

confidence: 99%

Effect of Immediate Initiation of Antiretroviral Treatment in HIV-Positive Individuals Aged 50 Years or Older

Lodi

Costagliola

Sabin

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Clinical guidelines recommend immediate initiation of combined antiretroviral therapy (ART) for all HIV-positive individuals. However, those guidelines are based on trials of relatively young participants. Methods We included HIV-positive ART-naïve, AIDS-free individuals aged 50-70 years after 2004 in the HIV-CAUSAL Collaboration. We used the parametric g-formula to estimate the 5-year risk of all-cause and non-AIDS mortality under: i) immediate initiation at baseline, and initiation at CD4 count ii) <500 cells/mm3, and iii) <350 cells/mm3. Results were presented separately for the general HIV population and for a US Veterans cohort with high mortality. Results The study included 9596 individuals (28% US Veterans) with median [interquantile range] age of 55 [52,60] years and CD4 count 336 [182,513] at baseline. The 5-year risk of all-cause mortality was 0.40% (95% CI 0.10,0.71) lower for the general HIV population and 1.61% (95% CI 0.79,2.67) lower for US Veterans when comparing immediate initiation vs initiation at CD4<350 cells/mm3. The 5-year risk of non-AIDS mortality was 0.17% (95% CI -0.07,0.43) lower for the general HIV population and 1% (95% CI 0.31,2.00) lower for US Veterans when comparing immediate initiation vs initiation at CD4<350 cells/mm3. Conclusions Immediate initiation appears to reduce all-cause and non-AIDS mortality in patients aged 50-70 years.

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“…However, diagnostic accuracy of causes of death in HIV‐positive persons is hampered because of many factors, including low autopsy rates, increasing numbers of deaths outside of medical institutions, and logistic and legal difficulties in receiving appropriate information on clinical events occurring outside of study sites. Furthermore, different data sources, coding algorithms or classification systems may result in different patterns of causes of death .…”

Section: Introductionmentioning

confidence: 99%

Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study

et al. 2012

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Background Mortality among HIV‐infected persons is decreasing, and causes of death are changing. Classification of deaths is hampered because of low autopsy rates, frequent deaths outside of hospitals, and shortcomings of International Statistical Classification of Diseases and Related Health Problems (ICD‐10) coding. Methods We studied mortality among Swiss HIV Cohort Study (SHCS) participants (1988–2010) and causes of death using the Coding Causes of Death in HIV (CoDe) protocol (2005–2009). Furthermore, we linked the SHCS data to the Swiss National Cohort (SNC) cause of death registry. Results AIDS‐related mortality peaked in 1992 [11.0/100 person‐years (PY)] and decreased to 0.144/100 PY (2006); non‐AIDS‐related mortality ranged between 1.74 (1993) and 0.776/100 PY (2006); mortality of unknown cause ranged between 2.33 and 0.206/100 PY. From 2005 to 2009, 459 of 9053 participants (5.1%) died. Underlying causes of deaths were: non‐AIDS malignancies [total, 85 (19%) of 446 deceased persons with known hepatitis C virus (HCV) status; HCV‐negative persons, 59 (24%); HCV‐coinfected persons, 26 (13%)]; AIDS [73 (16%); 50 (21%); 23 (11%)]; liver failure [67 (15%); 12 (5%); 55 (27%)]; non‐AIDS infections [42 (9%); 13 (5%); 29 (14%)]; substance use [31 (7%); 9 (4%); 22 (11%)]; suicide [28 (6%); 17 (7%), 11 (6%)]; myocardial infarction [28 (6%); 24 (10%), 4 (2%)]. Characteristics of deceased persons differed in 2005 vs. 2009: median age (45 vs. 49 years, respectively); median CD4 count (257 vs. 321 cells/μL, respectively); the percentage of individuals who were antiretroviral therapy‐naïve (13 vs. 5%, respectively); the percentage of deaths that were AIDS‐related (23 vs. 9%, respectively); and the percentage of deaths from non‐AIDS‐related malignancies (13 vs. 24%, respectively). Concordance in the classification of deaths was 72% between CoDe and ICD‐10 coding in the SHCS; and 60% between the SHCS and the SNC registry. Conclusions Mortality in HIV‐positive persons decreased to 1.33/100 PY in 2010. Hepatitis B or C virus coinfections increased the risk of death. Between 2005 and 2009, 84% of deaths were non‐AIDS‐related. Causes of deaths varied according to data source and coding system.

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Differences in the causes of death of HIV-positive patients in a cohort study by data sources and coding algorithms

Cited by 29 publications

References 8 publications

All-cause and liver-related mortality in HIV positive subjects compared to the general population: Differences by HCV co-infection

All-cause and liver-related mortality in HIV positive subjects compared to the general population: Differences by HCV co-infection

Effect of Immediate Initiation of Antiretroviral Treatment in HIV-Positive Individuals Aged 50 Years or Older

Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study

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