Trends in perimortal conditions and mortality rates among HIV-infected patients

Hooshyar, Dina; Hanson, Debra L.; Wolfe, Mary E.; Selik, Richard M.; Buskin, Susan E.; McNaghten, A. D.

doi:10.1097/qad.0b013e3282e9a664

Cited by 80 publications

(54 citation statements)

References 29 publications

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“…The nevirapine results (HIVNET 012) set the stage for more innovative and more efficacious preventive strategies which extended the use of nevirapine during lactation for up to 14 weeks [45][46][47] as well as trials to reduce emergency of resistance to nevirapine through addition of such drugs as zidovudine and lamivudine to nevirapine [48]. [50][51][52][53][54][55] with reductions in deaths due to AIDS-defining comorbidities [53]. ART did not only serve a treatment role but also provide additional tools for HIV prevention.…”

Section: -Triple Antiretroviral Therapymentioning

confidence: 99%

The History of the HIV/AIDS Epidemic in Africa

Kagaayi

Serwadda

2016

Curr HIV/AIDS Rep

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HIV testing of African immigrants in Belgium showed that HIV existed among Africans by 1983. However, the epidemic was recognized much later in most parts of sub-Saharan Africa (SSA) due to stigma and perceived fear of possible negative consequences to the countries' economies. This delay had devastating mortality, morbidity, and social consequences. In countries where earlier recognition occurred, political leadership was vital in mounting a response. The response involved establishment of AIDS control programs and research on the HIV epidemiology and candidate preventive interventions. Over time, the number of effective interventions has grown; the game changer being triple antiretroviral therapy (ART). ART has led to a rapid decline in HIV-related morbidity and mortality in addition to prevention of onward HIV transmission. Other effective interventions include safe male circumcision, pre-exposure prophylaxis, and post-exposure prophylaxis. However, since none of these is sufficient by itself, delivering a combination package of these interventions is important for ending the HIV epidemic as a public health threat.

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Section: -Triple Antiretroviral Therapymentioning

confidence: 99%

The History of the HIV/AIDS Epidemic in Africa

Kagaayi

Serwadda

2016

Curr HIV/AIDS Rep

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“…[12][13][14] Research also shows that HIV infection directly affects other organ systems, manifesting as chronic conditions including HIV-associated neurocognitive disorder and pulmonary hypertension. Such findings have important implications for clinicians caring for HIV-infected patients, as the co-management of HIV and other diseases may be complicated by issues such as polypharmacy and medication-associated toxicities-highlighting the need for comprehensive, coordinated care.…”

Section: Changing Patients: Morbidity Mortality and Agingmentioning

confidence: 99%

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

2011

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Since the beginning of the AIDS epidemic, models of HIV care have needed to be invented or modified as the needs of patients and communities evolved. Early in the epidemic, primary care and palliative care predominated; subsequently, the emergence of effective therapy for HIV infection led to further specialization and a focus on increasingly complex antiretroviral therapy as the cornerstone of effective HIV care. Over the past decade, factors including (1) an aging, long-surviving population; (2) multiple co-morbidities; (3) polypharmacy; and (4) the need for chronic disease management have led to a need for further evolution of HIV care models. Moreover, geographic diffusion; persistent disparities in timely HIV diagnosis, treatment access, and outcomes; and the aging of the HIV provider workforce also suggest the importance of reincorporating primary care providers into the spectrum of HIV care in the current era. Although some HIV-dedicated treatment centers offer comprehensive medical services, other models of HIV care potentially exist and should be developed and evaluated. In particular, primary care-and community-based collaborative practices-where HIV experts or specialists are incorporated into existing health centers-are one approach that combines the benefits of HIV-specific expertise and comprehensive primary care using an integrated, patient-centered approach.

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“…Furthermore, the proportion of deaths due to AIDS-defining conditions among HIV-infected individuals has decreased, while the proportion of deaths due to other causes, such as non-AIDS-defining malignancies, liver disease, pulmonary diseases, and cardiovascular disease, has increased [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

2010

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HIV-infected individuals with access to highly active antiretroviral therapy (HAART) are living longer and the causes of excess morbidity and mortality among people living with HIV/AIDS (PLWHA) are becoming comparable to individuals without HIV infection. However, many PLWHA smoke cigarettes-a well known contributor to excess morbidity and mortality. To investigate the association between smoking and mortality among PLWHA during the HAART era (1996+), we conducted a retrospective cohort study of 2,108 PLWHA enrolled in Seattle and King County's Adult and Adolescent Spectrum of HIV Disease Study. Adjusted hazard ratios (aHRs) for all-cause and cause-specific mortality were obtained using Cox proportional hazards regression. Compared to never smokers, current smokers (aHR = 1.8, 95% CI: 1.3, 2.3) and individuals with an increased dose and/or duration of smoking were at greater risk of all-cause mortality. Although additional research is needed to evaluate the full effect of smoking on cause-specific mortality, smoking cessation programs should target PLWHA to further increase their life expectancy.

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Trends in perimortal conditions and mortality rates among HIV-infected patients

Abstract: Among HIV-infected patients, the majority of whom were prescribed ART, the increasing trend in common noninfectious perimortal conditions support screening and treatment for these conditions in order to sustain the trend in declining mortality rates.

Cited by 80 publications

References 29 publications

The History of the HIV/AIDS Epidemic in Africa

The History of the HIV/AIDS Epidemic in Africa

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

Cigarette Smoking and Mortality Among HIV-Infected Individuals in Seattle, Washington (1996–2008)

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