February 4, 2013

Mortality Rates Among People With HIV, Long on the Wane, Continue to Drop

Even nearly two decades into the modern antiretroviral (ARV) era, the risk of death continues to drop for people living with HIV, aidsmap reports. Publishing their report in HIV Medicine, researchers from the Swiss HIV Cohort Study examined records of 16,134 citizens receiving HIV care between 1988 and 2010, of whom 5,023 (31 percent) died.

In the era preceding ARVs, 1988–1995, 78 percent of the deaths were caused by AIDS, a figure that fell to 15 percent in the period spanning 2005 and 2010. At its peak in 1992, AIDS-related mortality reached a rate of 11 per 100 person-years and then plummeted to 0.144 by 2006. Mortality due to non-AIDS-related causes dropped from 1.74 per 100 person-years in 1996 to 0.776 in 2003 and to 0.26 in 2010.

Between 2005 and 2009, 259 people (5 percent) died, at a median age of 47, resulting in a mortality rate of 1.25 per 100 person-years. About 45 percent of this group was coinfected with hepatitis C virus (HCV) and 11 percent with hepatitis B virus (HBV). Non-AIDS-related cancers made up the most common cause of death, at 19 percent, followed by AIDS (16 percent), liver failure (15 percent), non-AIDS related infections (9 percent), substance abuse (7 percent), suicide (6 percent) and heart attack (6 percent).

The demographics of those who died between 2005 and 2009 showed promising signs: The median age at death increased from 45 to 49; the median years of life with HIV before death went from 13 to 16 years; median CD4 cell counts increased from 257 to 321; and the proportion of those who had never been treated with ARVs dropped from 13 to 5 percent.

Risk factors associated with increased likelihood of death included injection drug use, lower CD4 count, smoking, diabetes, low body mass index, HBV or HCV coinfection, and the interruption of ARV treatment.

To read the aidsmap story, click here.

To read the study abstract, click here.

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