Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings.
Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings.
复制标题
欧洲高收入地区接受抗逆转录病毒治疗者超额死亡率趋势和模式的参数估计。
DOI：
10.1097/qad.0000000000002387
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Obel,Ni
中科院分区：
文献类型：
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作者：
Trickey,Adam;vanSighem,Ard;Stover,John;Abgrall,Sophie;Grabar,Sophie;Bonnet,Fabrice;Berenguer,Juan;Wyen,Christoph;Casabona,Jordi;d'ArminioMonforte,Antonella;Cavassini,Matthias;DelAmo,Julia;Zangerle,Robert;Gill,MJohn;Obel,Ni
方法：分析来自奥地利、丹麦、法国、意大利、荷兰、西班牙和瑞士的抗逆转录病毒治疗队列合作项目（ART-CC） 2000年至2015年的数据。采用灵活参数模型比较ART-CC和Spectrum的全因死亡率。对艾滋病相关死亡和超额死亡率的百分比（两者在谱内相同）进行了比较，超额死亡率的定义是超过一般人口死亡率。结果：分析包括94 026例PLHIV患者，随访585 784人-年，其中5515例死亡。2000-2003年，Spectrum的全因年死亡率为0.0121,2012-2015年降至0.0078，而ART-CC相应的年死亡率为0.0151[95%可信区间（95% CI）： 0.0130-0.0171]，降至0.0049 （95% CI: 0.0039-0.0060）。2000-2003年，频谱地区艾滋病相关死亡率为74.7%，2012-2015年降至43.6%。在ART-CC中，艾滋病相关死亡率占2000-2003年死亡率的45.3%(95% CI: 38.4-52.9%)， 2012 - 2015年期间占26.7%（95% CI: 19-46%）。ART-CC的超额死亡率与Spectrum估计大致相似，从2000-2003年的75.3%（95% CI: 60.3-95.2%）下降到2012-2015年的30.7%（95% CI: 25.5-63.7%）。结论：在高收入的欧洲环境中，抗逆转录病毒治疗hiv的全因死亡率假设应该在频谱中进行调整，使2000-2003年更高，并更快地下降到近年来目前捕获的水平。
Methods:Data from 2000 to 2015 were analysed from the Antiretroviral Therapy Cohort Collaboration (ART-CC) for Austria, Denmark, France, Italy, the Netherlands, Spain, and Switzerland. Flexible parametric models were used to compare all-cause mortality rates in the ART-CC and Spectrum. The percentage of AIDS-related deaths and excess mortality (both are the same within Spectrum) were compared, with excess mortality defined as that in excess of the general population mortality.Results:Analyses included 94 026 PLHIV with 585 784 person-years of follow-up, from which there were 5515 deaths. All-cause annual mortality rates in Spectrum for 2000–2003 were 0.0121, reducing to 0.0078 in 2012–2015, whilst the ART-CC's corresponding annual mortality rates were 0.0151 [95% confidence interval (95% CI): 0.0130–0.0171] reducing to 0.0049 (95% CI: 0.0039–0.0060). The percentage of AIDS-related deaths in Spectrum was 74.7% in 2000–2003, dropping to 43.6% in 2012–2015. In the ART-CC, AIDS-related mortality constitutes 45.3%(95% CI: 38.4–52.9%) of mortality in 2000–2003 and 26.7%(95% CI: 19–46%) between 2012 and 2015. Excess mortality in the ART-CC was broadly similar to the Spectrum estimates, dropping from 75.3%(95% CI: 60.3–95.2%) in 2000–2003 to 30.7%(95% CI: 25.5–63.7%) in 2012–2015.Conclusion:All-cause mortality assumptions for PLHIV on ART in high-income European settings should be adjusted in Spectrum to be higher in 2000–2003 and decline more quickly to levels currently captured for recent years.