[Trends in mortality and causes of death among persons with HIV infection, 1985-2004].
OBJECTIVE
To describe the changes in causes of death among persons with HIV infection.


METHODS
An analysis of mortality according to cause was performed in persons diagnosed with HIV infection and residing in the province of Navarre (Spain) from 1985 to 2004.


RESULTS
Among 1,649 persons diagnosed with HIV infection up to 2004, 709 (43.0%) had died. Mortality reached the maximum in 1993-1996 with 83.1 deaths per 1,000 person-years (PY). Since that time and up to 2001-2004, mortality due to AIDS decreased from 68.3 to 14.1 per 1,000 PY (p = 0.0001). From 1989-1992 period to the 2001-2004 period, mortality due to drug overdose dropped from 9.2 to 3.6 per 1,000 PY (p = 0.0035) and mortality due to hepatic disease rose from 1.6 to 6.6 per 1000 PY (p = 0.0061), with no significant changes in all other causes. In 2001-2004, AIDS continued to be the first cause of death (44.4%) in this population, followed by hepatic disease (20.9%) and drug overdose (11.3%). In the era of potent antiretroviral therapy (1997-2004), death caused by AIDS (rate ratio = 0.63; p = 0.0344) and by all other causes (RR = 0.59; p = 0.0232) was lower among women. In addition, mortality due to causes other than AIDS was higher in persons 40 years of age and older (RR = 1.77; P = 0.0050) and mortality was lower in homosexual men (RR = 0.22; p = 0.0360). A simultaneous diagnosis of HIV infection and AIDS was associated with higher mortality by AIDS (RR, 3.39; p < 0.0001).


CONCLUSIONS
AIDS continues to be the primary cause of death in HIV-infected people, and mortality due to hepatic diseases and drug overdose is high. Early diagnosis of HIV-infection would reduce the incidence of deaths due to AIDS.
Aldaz
Pablo
P
Instituto de Salud Pública de Navarra, Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Spain.
Castilla
Jesús
J
Moreno-Iribas
Conchi
C
Irisarri
Fátima
F
Floristán
Yugo
Y
Sola-Boneta
Julio
J
Martínez-Artola
Víctor
V
Fernández-Jaúregui
Carmen
C
Dorronsoro
Inés
I
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality / Q000517:prevention & control; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D002423:Cause of Death; D018450:Disease Progression; D062787:Drug Overdose / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008107:Liver Diseases / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000401:mortality
D019380:Anti-HIV Agents