Gender difference in all‐cause mortality of people living with HIV in Iran: findings from a 20‐year cohort study

Abstract

Gender differences in the efficacy of treatment and the mortality of HIV-infected patients have not yet been fully elucidated. For the first time, we used data from a 20-year cohort of people living with HIV (PLWH) in four provinces (Fars, Bushehr, Bandar Abbas, and Kohgiluyeh and Boyer-Ahmad) in the southern part of Iran to assess the gender difference in all-cause mortality in PLWH in Iran. Methods We analysed data for 1216 patients aged ≥ 15 years who were diagnosed with HIV/AIDS between 1997 and 2017. Three hundred and fourteen (25.8%) were women. Results The death rate from all causes among women was 13.7% vs. 43.8% among men (P < 0.001). Allcause mortality was significantly associated with gender [the adjusted hazard ratio (aHR) for men compared with women was 3.20], not being on antiretroviral therapy (ART) compared with being on ART at the last visit (aHR 5.42), older age (aHR 1.03), delayed HIV diagnosis compared with early diagnosis (aHR 1.72), history of incarceration (aHR 1.57), higher log CD4 count at diagnosis (aHR 0.54), and prophylaxis for Pneumocystis pneumonia (aHR 0.09). Conclusions The results of this 20-year cohort study suggest that gender is an important predictor of survival among HIV-infected patients. Improving early HIV diagnosis and early ART initiation in men, as well as increased access to hepatitis C virus treatment are needed to increase the survival rate of HIV-infected patients in Iran.

Longitudinal impact of compliance with routine CD4 monitoring on all cause deaths among treated people with HIV in China

“…Several published studies have shown correlation between gender and risk of death in HIV-infected patients (30,31). Women had lower risks of both AIDS-related and NCDs-related deaths than men in the present study.…”

Development and Evaluation of Rapid and Accurate CRISPR/Cas13-Based RNA Diagnostics for Pneumocystis jirovecii Pneumonia

“…PJP was once the main complication and leading cause of death in AIDS patients ( Djawe et al., 2015 ). It accounted for 36% of the mortality in HIV-infected patients ( Gheibi et al., 2020 ). Since the application of antiretroviral therapy, the morbidity due to PJP has decreased significantly from 54.6% to 30.4%, with 5-year survival probabilities increasing from 1% to 69% and the mortality decreasing to 6.7% ( Su et al., 2008 ; Djawe et al., 2015 ; Calvo-Lozano et al., 2020 ).…”