Mortality of HIV-infected patients with or without cancer: comparison with the general population in Italy
Mortality of HIV-infected patients with or without cancer: comparison with the general population in Italy
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DOI：
10.3851/imp1984
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发表时间：
2012-01-01
影响因子：
1.2
通讯作者：
Castagna, Antonella
中科院分区：
文献类型：
--
作者：
Galli, Laura;Spagnuolo, Vincenzo;Castagna, Antonella
背景：HAART降低了HIV感染患者的死亡率;然而，非艾滋病相关事件的风险增加了，包括癌症。我们比较了死亡率在艾滋病毒感染的患者有或没有癌症与一般人群在意大利。方法：符合条件的患者记录在圣拉斐尔传染病部门的数据库。观察到的死亡与预期全因死亡的比率（标准化死亡率[SMR]）按年龄和性别标准化，并按癌症发生率或HIV感染年份分层（1998年）。预期的全因死亡数据来自于Istituto Patioredi Sanita（罗马，意大利; 2002年数据）。结果：在6,495例HIV感染患者中，贡献了75,171人-年，SMR为6.0（95%CI 5.7，6.4）; SMR随年龄增加而降低。无论是否患有癌症，患者的死亡率均显著高于一般人群（SMR分别为15.1 [95% CI 13.6，16.7]和4.8 [95% CI 4.5，5.1]）。对于有或无癌症的患者，年龄1998岁的患者的SMR较高，年龄调整的SMR范围为216.0（95% CI 43.4，631.3）至6.8（95% CI 4.7，9.7）。结论：在意大利，艾滋病毒感染者的死亡率仍然高于一般人口，而且根据年龄有显著差异，和癌症导致死亡率过高。
Background: HAART has reduced mortality in HIV-infected patients; however, the risk of non-AIDS-related events has increased, including cancer. We compared mortality in HIV-infected patients with or without cancer with the general population in Italy.Methods: Eligible patients were recorded in the San Raffaele Infectious Diseases Department database. The ratio of observed deaths to expected all-cause deaths (standardized mortality ratio [SMR]) was standardized for age and gender, and stratified by cancer occurrence or year of HIV infection (1998). Expected all-cause deaths were obtained from the Istituto Superiore di Sanita (Rome, Italy; 2002 data).Results: Among 6,495 HIV-infected patients, contributing 75,171 person-years, the SMR was 6.0 (95% CI 5.7, 6.4); SMRs decreased as age increased. Mortality rates were significantly higher than the general population for patients with or without cancer (SMR=15.1 [95% CI 13.6, 16.7] and 4.8 [95% CI 4.5, 5.1], respectively). For patients with or without cancer, SMRs were higher in those aged 1998, age-adjusted SMRs ranged from 216.0 (95% CI 43.4, 631.3) to 6.8 (95% CI 4.7, 9.7) in patients = 70 years, respectively.Conclusions: Mortality in HIV-infected patients remains higher than the general population in Italy, with marked differences according to age, and cancer contributing to an increased excess of mortality.