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Changing mortality rates and causes of death for HIV-infected individuals living in Southern Alberta, Canada from 1984 to 2003.

https://arctichealth.org/en/permalink/ahliterature175432
Source
HIV Med. 2005 Mar;6(2):99-106
Publication Type
Article
Date
Mar-2005
Author
H B Krentz
G. Kliewer
M J Gill
Author Affiliation
Southern Alberta Clinic, Calgary, Alberta, Canada. harmut.krentz@calgaryhealthregion.ca
Source
HIV Med. 2005 Mar;6(2):99-106
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - mortality
Alberta
Antiretroviral Therapy, Highly Active
Antiviral agents - therapeutic use
Cause of Death - trends
Disease Progression
Drug Resistance, Multiple, Viral
HIV Infections - complications - drug therapy - mortality
Humans
Lymphoma, Non-Hodgkin - mortality - virology
Mycobacterium avium-intracellulare Infection - mortality - virology
Pneumonia, Pneumocystis - mortality - virology
Socioeconomic Factors
Substance Abuse, Intravenous
Treatment Refusal
Abstract
To examine changes over a 2-year period in both the mortality rate and the causes of death in a geographically defined HIV-infected population.
A database search of primary care information for the dates and causes of death for all patients documented with HIV infection and living in Southern Alberta between 1984 and 2003 was undertaken. Sociodemographic and clinical characteristics were obtained. Causes of death were then individually confirmed by reviewing the patients' hospital charts, autopsy reports, or death certificates and coded using the International Classification of Diseases, 9th Revisions. AIDS deaths were reconciled with Public Health Reports. The time span was divided into pre-highly active antiretroviral therapy (HAART) (1984-1996) and current HAART (1997-2003) periods.
Between 1984 and 2003, there were 560 deaths in the 1987 individuals living with HIV infection in Southern Alberta. Of these, 436 deaths (78%) occurred pre-HAART and 124 (22%) in the current HAART period. The crude mortality rate declined from 117 deaths per 1000 patient-years pre-HAART to 24 in the current HAART period. In the pre-HAART era, 90% of all deaths were AIDS related whereas only 67% were AIDS related in the current HAART era. The leading causes of AIDS deaths were AIDS multiple causes (31%), Mycobacterium avium complex (18%), Pneumocystis pneumonia (10%) and non-Hodgkin's lymphoma (7%). The proportion of non-AIDS related deaths increased from 7% pre-HAART to 32% in the current HAART era. Accidental deaths, including drug overdose (29%), suicide (7%) and violence (3%), hepatic disease (19%), non-AIDS related malignancies (19%), and cardiovascular disease (16%) accounted for the majority of non-AIDS related deaths. No deaths directly caused by drug toxicity were found. Overall, 21% of patients who died were antiretroviral (ARV)-naive. A total of 14% of patients dying from AIDS were ARV-naive in contrast to 35% dying from non-HIV related conditions. Of all those dying from AIDS, 23% died
PubMed ID
15807715 View in PubMed
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