Trends in causes of death among persons with acquired immunodeficiency syndrome in the era of highly active antiretroviral therapy, San Francisco, 1994-1998.
To understand recent temporal trends in acquired immunodeficiency syndrome (AIDS) mortality in the era of highly active antiretroviral therapy (HAART), trends in causes of death among persons with AIDS in San Francisco who died between 1994 and 1998 were analyzed. Among 5234 deaths, the mortality rate for human immunodeficiency virus (HIV)-related or AIDS-related deaths declined after 1995 (P<.01), whereas the mortality rate for non-HIV- or non-AIDS-related deaths remained stable. The proportion of deaths of persons with AIDS associated with septicemia, non-AIDS-defining malignancy, chronic liver disease, viral hepatitis, overdose, obstructive lung disease, coronary artery disease, and pancreatitis increased (P<.05). The standardized mortality ratio was high for these causes in both pre- and post-HAART periods, except for pancreatitis, a possible complication of HAART, which demonstrated an increasing standardized mortality ratio trend after 1996. With increasing AIDS survival, prevention of chronic diseases, assessment of long-term toxicity from HAART, and surveillance for additional causes of mortality will become increasingly important.
Louie
Janice K
JK
Center for AIDS Prevention Studies, University of California, San Francisco, CA 94105, USA. JLouie@psg.ucsf.edu
Hsu
Ling Chin
LC
Osmond
Dennis H
DH
Katz
Mitchell H
MH
Schwarcz
Sandra K
SK
D017088:AIDS-Related Opportunistic Infections / Q000401:mortality*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002423:Cause of Death / Q000639:trends*; D003324:Coronary Artery Disease / Q000150:complications; D062787:Drug Overdose; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008107:Liver Diseases / Q000150:complications; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D009369:Neoplasms / Q000150:complications; D010195:Pancreatitis / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D018805:Sepsis / Q000150:complications
D019380:Anti-HIV Agents