Impact of non-HIV and HIV risk factors on survival in HIV-infected patients on HAART: a population-based nationwide cohort study.
Impact of non-HIV and HIV risk factors on survival in HIV-infected patients on HAART: a population-based nationwide cohort study.
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DOI：
10.1371/journal.pone.0022698
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Gerstoft J
中科院分区：
文献类型：
--
作者：
Obel N;Omland LH;Kronborg G;Larsen CS;Pedersen C;Pedersen G;Sørensen HT;Gerstoft J
我们确定了三个因素对接受高效抗逆转录病毒治疗 (HAART) 至少一年的 HIV 感染者死亡率的影响：(1) 对 (HAART) 反应不足和存在艾滋病定义疾病，(2) 合并症，以及 (3) 药物和酒精滥用，并将死亡率与普通人群的死亡率进行了比较。在丹麦全国性的、基于人群的队列研究中，我们使用基于人群的登记来识别（1）所有在1998年1月1日至2009年7月1日期间开始HAART的丹麦HIV感染者，以及（2）出生日期和性别匹配的个人比较队列（N = 2,267和9,068，分别）。研究纳入在 HAART 开始一年后开始。根据研究纳入前确定的三个危险因素，将患者分为四组。主要结果指标是 25 岁至 65 岁的生存概率。与对照组[0.88（0.86至0.90）]相比，HIV患者从25岁到65岁的生存概率明显较低[0.48（95%置信区间（CI）0.42-0.55）]。然而，在没有危险因素的 HIV 患者中 (N = 871)，生存概率与一般人群相当 [0.86 (95% CI 0.77–0.92)]。相比之下，有HIV危险因素的患者的生存概率为0.58（N = 704），有合并症的患者为0.30（N = 479），吸毒或酗酒的患者为0.03（N = 313）。 HIV感染者死亡风险增加主要归因于在抗逆转录病毒治疗之前或治疗初期可以识别的危险因素。没有危险因素的患者在成功进行HAART后的死亡率几乎与非HIV感染者的死亡率相同。
We determined the impact of three factors on mortality in HIV-infected patients who had been on highly active antiretroviral therapy (HAART) for at least one year: (1) insufficient response to (HAART) and presence of AIDS-defining diseases, (2) comorbidity, and (3) drug and alcohol abuse and compared the mortality to that of the general population. In a Danish nationwide, population-based cohort study, we used population based registries to identify (1) all Danish HIV-infected patients who started HAART in the period 1 January 1998–1 July 2009, and (2) a comparison cohort of individuals matched on date of birth and gender (N = 2,267 and 9,068, respectively). Study inclusion began 1 year after start of HAART. Patients were categorised hierarchically in four groups according to the three risk factors, which were identified before study inclusion. The main outcome measure was probability of survival from age 25 to 65 years. The probability of survival from age 25 to age 65 was substantially lower in HIV patients [0.48 (95% confidence interval (CI) 0.42–0.55)] compared to the comparison cohort [0.88 (0.86 to 0.90)]. However, in HIV patients with no risk factors (N = 871) the probability of survival was equivalent to that of the general population [0.86 (95% CI 0.77–0.92)]. In contrast, the probability of survival was 0.58 in patients with HIV risk factors (N = 704), 0.30 in patients with comorbidities (N = 479), and 0.03 in patients with drug or alcohol abuse (N = 313). The increased risk of death in HIV-infected individuals is mainly attributable to risk factors that can be identified prior to or in the initial period of antiretroviral treatment. Mortality in patients without risk factors on a successful HAART is almost identical to that of the non–HIV-infected population.
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影响因子：
11.8
作者：
Savès, M;Chêne, G;Raffi, F
通讯作者：
Raffi, F
影响因子：
168.9
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Lodwick, Rebecca K.;Sabin, Caroline A.;Porter, Kholoud;Ledergerber, Bruno;van Sighem, Ard;Cozzi-Lepri, Alessandro;Khaykin, Pavel;Mocroft, Amanda;Jacobson, Lisa;De Wit, Stephane;Obel, Niels;Castagna, Antonella;Wasmuth, Jan-Christian;Gill, John;Klein, Manna B.;Gange, Stephen;Riera, Melchor;Mussini, Cristina;Gutierrez, Felix;Touloumi, Giota;Carrieri, Patrizia;Guest, Jodie L.;Brockmeyer, Norbert H.;Phillips, Andrew N.
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Phillips, Andrew N.
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Hirschel, B
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通讯作者：
Obel, Niels
影响因子：
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作者：
Weis, N;Lindhardt, BO;Obel, N
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