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Non-AIDS Mortality Is Higher Among Successfully Treated People Living with HIV Compared with Matched HIV-Negative Control Persons: A 15-Year Follow-Up Cohort Study in Sweden.

Artikel i vetenskaplig tidskrift
Författare Zaake de Coninck
Laith Hussain-Alkhateeb
Göran Bratt
Anna Mia Ekström
Magnus Gisslén
Max Petzold
Veronica Svedhem
Publicerad i AIDS patient care and STDs
Volym 32
Nummer/häfte 8
Sidor 297-305
ISSN 1557-7449
Publiceringsår 2018
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin
Institutionen för biomedicin, avdelningen för infektionssjukdomar
Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri
Sidor 297-305
Språk en
Länkar dx.doi.org/10.1089/apc.2018.0015
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Folkhälsovetenskap, Infektionsmedicin

Sammanfattning

There is an ongoing debate whether the life span of successfully treated people living with HIV (PLHIV) is comparable with that of the general population. The aim of this cohort study is to compare all-cause mortality between all PLHIV, successfully treated PLHIV, and HIV-negative control persons from the general population and to explore the impact of viral load (VL) at diagnosis. A total of 4066 PLHIV were matched against 8072 HIV-negative controls according to age, sex, and region of birth. Further, associations between VL at diagnosis, time on treatment, treatment outcome, and mortality were assessed over a 15-year period. Cox regression estimates were computed to compare the overall crude and adjusted hazard ratios (HRs) for mortality. After a 15-year follow-up period, successfully treated PLHIV were found to be three times more likely to die when compared with HIV-negative controls (HR 3.01, 95% CI 2.05-4.44, p < 0.001). The risk of mortality decreased from HR 6.02 after the first year of successful treatment. VL >30,000 c/mL at diagnosis was associated with an increased risk of mortality despite long-term antiretroviral therapy (ART) treatment. Although effective viral suppression has led to significant increases in longevity and quality of life, ART has not fully restored life expectancy to a level comparable with that found in HIV-negative persons. Even when PLHIV are successfully treated, there are several other important areas related to death, such as smoking and social factors, where data are still missing.

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