title: Liver-related deaths in HIV-infected patients between 1995 and 2005 in the French GERMIVIC Joint Study Group Network (Mortavic 2005 study in collaboration with the Mortalité 2005 survey, ANRS EN19).
abstract: BACKGROUND
  More than 10 years after the introduction of combination antiretroviral therapy (cART), we examined the trend in the proportion of deaths caused by end-stage liver disease (ESLD) in HIV-infected adults in France between 1995 and 2005.
  
  
  METHODS
  In 2005, 34 departments prospectively recorded all deaths in HIV-infected patients who were followed in those departments (around 24 000).
  
  
  RESULTS
  were compared with those of four previous cross-sectional surveys conducted since 1995 using the same methodology. Results Among 287 reported deaths in 2005, 100 (35%) were related to AIDS, and 48 (17%) to ESLD. Three out of four patients who died from ESLD-related causes had chronic hepatitis C. Excessive alcohol consumption was reported in approximately half of the patients (48%). At death, 62% of patients had undetectable HIV viral load and the median CD4 count was 237 cells/microL. From 1995 to 2005, the proportion of deaths caused by ESLD increased from 2 to 17% (P<0.001). The proportion of deaths caused by hepatocellular carcinoma increased from 5% in 1995 to 25% in 2005 (P=0.0337).
  
  
  CONCLUSIONS
  Over the 10 years from 1995 to 2005, the proportion of deaths caused by hepatitis C virus-related ESLD has increased in HIV-infected patients. ESLD is currently a leading cause of death in this population, with hepatocellular carcinoma representing a quarter of liver-related deaths. Recommendations for the detection of hepatocellular carcinoma should be strictly applied in these patients.
authors.affiliation: Department of Internal Medicine, Archet Hospital Centre, University of Nice-Sophia Antipolis, Nice, France. rosenthal.e@chu-nice.fr
authors.forename: E
authors.initials: E
authors.lastname: Rosenthal
authors.forename: D
authors.initials: D
authors.lastname: Salmon-Céron
authors.forename: C
authors.initials: C
authors.lastname: Lewden
authors.forename: V
authors.initials: V
authors.lastname: Bouteloup
authors.forename: G
authors.initials: G
authors.lastname: Pialoux
authors.forename: F
authors.initials: F
authors.lastname: Bonnet
authors.forename: M
authors.initials: M
authors.lastname: Karmochkine
authors.forename: T
authors.initials: T
authors.lastname: May
authors.forename: M
authors.initials: M
authors.lastname: François
authors.forename: C
authors.initials: C
authors.lastname: Burty
authors.forename: E
authors.initials: E
authors.lastname: Jougla
authors.forename: D
authors.initials: D
authors.lastname: Costagliola
authors.forename: P
authors.initials: P
authors.lastname: Morlat
authors.forename: G
authors.initials: G
authors.lastname: Chêne
authors.forename: P
authors.initials: P
authors.lastname: Cacoub
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000401:mortality; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000401:mortality*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000401:mortality*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins