Shift of HIV/AIDS Deaths to an Older Age and Gender Difference: Inferences Derived from the Vital Statistics of Japan

Yasuda, Hiroshi

doi:10.7883/yoken.jjid.2019.005

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…A study from Japan showed non-AIDS-defining malignancies and suicide comprised 23% and 8.5% of all deaths in the ART era [19]. Analysis of Japanese vital statistics has shown the same trend seen in our study [20]. In Japan, the age-adjusted incidence rate of allsite malignancies in HIV population in 2018 was calculated 372.9/ 100,000 people.…”

Section: Discussionsupporting

confidence: 86%

Changes in survival and causes of death among people living with HIV: Three decades of surveys from Tokyo, one of the Asian metropolitan cities

Tsuda

Koga

Nojima

et al. 2021

Journal of Infection and Chemotherapy

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Introduction: Survival among people living with HIV (PLWH) has dramatically improved in the antiretroviral therapy (ART) era. This is the first study in Asia to describe three decades of surveys on survival and causes of death among PLWH. Methods: We included 1121 HIV-infected patients, categorized into three period groups according to date of first visit: 1986e1996 (Pre-ART); 1997e2007 (Early-ART); and 2008e2018 (Late-ART). Results: Ten-year all-cause mortality has reduced from Pre-ART (49.6/1000 person-years) to Late-ART (6.3/1000 person-years). Mortality for AIDS-defining illnesses (ADIs) has also reduced from Pre-ART (34.4/1000 person-years) to Late-ART (2.9/1000 person-years), and mortality for non-ADIs has reduced from Pre-ART (11.7/1000 person-years) to Late-ART (2.9/1000 person-years). In the ART-era, deaths from non-AIDS-defining malignancies and unnatural events including suicide represented the majority of non-ADI-related deaths and mortality rates of non-AIDS defining malignancies and unnatural cause event were not different between each group (3.4, 1.9 and 2.5/1000 person-years). Crude cumulative survival improved over the study period, and 10-year survival ratios of HIV-infected patients to the general Japanese population approached 1.00, from Pre-ART (0.66) to Late-ART (0.99). Even in the Late-ART period, survival remained lower in patients with a history of ADIs than in those without, but the difference in 5-year mortality between these groups has shrunk in the Late-ART compared to the Pre-ART. Conclusions: Mortality for ADIs and non-ADIs in PLWH has reduced in the Early-ART and Late-ART. To improve survival for PLWH further, early HIV detection and treatment and good management of non-AIDS-defining malignancies and mental disorders are needed. (248/250).

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Section: Discussionsupporting

confidence: 86%

Changes in survival and causes of death among people living with HIV: Three decades of surveys from Tokyo, one of the Asian metropolitan cities

Tsuda

Koga

Nojima

et al. 2021

Journal of Infection and Chemotherapy

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“…All authors declare that they have no con ict of interest or nancial con icts to disclose. Authors' contributions GF, LW 6 , and ZL curated and provided data. ZL and JX screened the data.…”

Section: Consent For Publicationmentioning

confidence: 99%

“…Studies have shown that CD4 + T lymphocytes (CD4), CD8 + T lymphocytes (CD8), and viral load (HIV RNA) before treatment are closely associated with the mortality of PLHIV [5][6][7][8][9][10][11][12][13] . Clinical indicators are reported to have a close association with death risk of PLHIV [5,7−16] .…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiviral treatment: a cohort between 2003 and 2019 in Nanjing

Jiang¹,

Xu²,

Liu³

et al. 2021

Preprint

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Background Although great achievements have been made since free antiviral treatment (ART) was available, an in-time and accurate prediction of survival for people living with HIV (PLHIV) is still needed for effective management. We aimed to establish an effective prognostic model to forecast the survival probability of PLHIV after ART. Methods The participants enrolled were from a follow-up cohort between 2003 and 2019 in Nanjing from Nanjing AIDS Prevention and Control Information System. The nested case-control study was employed with HIV-related death, and propensity-score matching (PSM) approach was applied at a ratio of 1:4 to allocate the patients. Univariate and multivariate Cox hazards analyses were used based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The calibration was evaluated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA). Results Predictive factors including CD4 cell count (CD4), body mass index (BMI) and food blood glucose (GLU) were determined and contained in the nomogram. In the training set, AUC and C-index (95% CI) were 0.826 and 0.793 (0.740, 0.846), respectively. The model of validation set still revealed good discrimination with an AUC and a C-index (95% CI) of 0.750 and 0.776 (0.711, 0.839). The calibration curve also exhibited a high consistency in predicting the survival of PLHIV (especially in the first three years after starting ART). Moreover, DCA demonstrated that the nomogram was clinically beneficial. Conclusion The nomogram is effective and accurate in forecasting the survival rate of PLHIV, and therefore accessible for medical workers in health administration.

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Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing

Jiang

Liu

et al. 2022

BMC Public Health

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Background Great achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after ART. Methods The participants were enrolled from a follow-up cohort over 2003-2019 in Nanjing AIDS Prevention and Control Information System. A nested case-control study was employed with HIV-related death, and a propensity-score matching (PSM) approach was applied in a ratio of 1:4 to allocate the patients. Univariable and multivariable Cox proportional hazards analyses were performed based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The nomogram was calibrated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA). Results Predictive factors including CD4 cell count (CD4), body mass index (BMI) and hemoglobin (HB) were determined and incorporated into the nomogram. In the training set, AUC and C-index (95% CI) were 0.831 and 0.798 (0.758, 0.839), respectively. The validation set revealed a good discrimination with an AUC of 0.802 and a C-index (95% CI) of 0.786 (0.681, 0.892). The calibration curve also exhibited a high consistency in the predictive power (especially in the first 3 years after ART initiation) of the nomogram. Moreover, DCA demonstrated that the nomogram was clinically beneficial. Conclusion The nomogram is effective and accurate in forecasting the survival of PLHIV, and beneficial for medical workers in health administration.

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Shift of HIV/AIDS Deaths to an Older Age and Gender Difference: Inferences Derived from the Vital Statistics of Japan

Cited by 3 publications

References 16 publications

Changes in survival and causes of death among people living with HIV: Three decades of surveys from Tokyo, one of the Asian metropolitan cities

Changes in survival and causes of death among people living with HIV: Three decades of surveys from Tokyo, one of the Asian metropolitan cities

Development and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiviral treatment: a cohort between 2003 and 2019 in Nanjing

Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing

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