Trends of mortality and causes of death among HIV-infected patients in Taiwan, 1984-2005
Journal
HIV Medicine
Journal Volume
9
Journal Issue
7
Pages
535-543
Date Issued
2008
Author(s)
Abstract
Background: The aim of this study was to analyse the trends of mortality and causes of death among HIV-infected patients in Taiwan from 1984 to 2005. Methods: Registered data and death certificates for HIV-infected patients from Taiwan Centers for Disease Control were reviewed. Mortality rate and causes of deaths were compared among patients whose HIV diagnosis was made in three different study periods: before the introduction of highly active antiretroviral therapy (HAART) (pre-HAART: from 1 January 1984 to 31 March 1997), in the early HAART period (from 1 April 1997 to 31 December 2001), and in the late HAART period (from 1 January 2002 to 31 December 2005). A subgroup of 1161 HIV-infected patients (11.4%) followed at a university hospital were analysed to investigate the trends of and risk factors for mortality. Results: For 10 162 HIV-infected patients with a mean follow-up of 1.97 years, the mortality rate of HIV-infected patients declined from 10.2 deaths per 100 person-years (PY) in the pre-HAART period to 6.5 deaths and 3.7 deaths per 100 PY in the early and late HAART periods, respectively (P < 0.0001). For the 1161 patients followed at a university hospital (66.8% with CD4 count <200 cells/μL), HAART reduced mortality by 89% in multivariate analysis, and the adjusted hazard ratio for death was 0.28 (95% confidence interval 0.24, 0.33) in patients enrolled in the late HAART period compared with those in the pre-HAART period. Seventy-six per cent of the deaths in the pre-HAART period were attributable to AIDS-defining conditions, compared with 36% in the late HAART period (P < 0.0001). The leading causes of non-AIDS-related deaths were sepsis (14.7%) and accidental death (8.3%), both of which increased significantly throughout the three study periods. Compared with patients acquiring HIV infection through sexual contact, injecting drug users were more likely to die from non-AIDS-related causes. Conclusions: The mortality of HIV-infected patients declined significantly after the introduction of HAART in Taiwan. In the HAART era, AIDS-related deaths decreased significantly while deaths from non-AIDS-related conditions increased. ? 2008 British HIV Association.
SDGs
Other Subjects
proteinase inhibitor; RNA directed DNA polymerase inhibitor; accidental death; acquired immune deficiency syndrome; adult; article; cause of death; CD4 lymphocyte count; controlled study; female; follow up; hazard ratio; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; intravenous drug abuse; major clinical study; male; mortality; multivariate analysis; nonhuman; priority journal; risk factor; sepsis; sexual transmission; Taiwan; trend study; university hospital; virus transmission; Adolescent; Adult; Aged; Aged, 80 and over; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Cause of Death; Child; Child, Preschool; Female; HIV Infections; Humans; Infant; Male; Middle Aged; Multivariate Analysis; Substance Abuse, Intravenous; Taiwan; Young Adult
Type
journal article