Trends in mortality and causes of death among women with HIV in the United States: a 10-year study.
BACKGROUND
To assess trends in mortality and cause of death for women with HIV, we studied deaths over a 10-year period among participants in the Women's Interagency HIV Study, a representative US cohort.


METHODS
Deaths were ascertained by National Death Index Plus match, and causes of death determined by death certificate.


RESULTS
From 1995 through 2004, 710 of 2792 HIV-infected participants died. During this interval, the standardized mortality ratio fell from a high of 24.7 in 1996 to a plateau with a mean of 10.3 from 2001 to 2004. Over the decade, deaths from non-AIDS causes increased and accounted for the majority of deaths by 2001-2004. The most common non-AIDS causes of death were trauma or overdose, liver disease, cardiovascular disease, and malignancy. Independent predictors of mortality besides HIV-associated variables were depressive symptoms and active hepatitis B or C. Women who were overweight or obese were significantly less likely to die of AIDS than women of normal weight.


CONCLUSIONS
In the Women's Interagency HIV Study, the death rate has plateaued in recent years. Although HIV-associated factors predicted AIDS and non-AIDS deaths, other treatable conditions predicted mortality. Further gains in reducing mortality among HIV-infected women may require broader access to therapies for depression, viral hepatitis, and HIV itself.
French
Audrey L
AL
CORE Center/Stroger (Cook County) Hospital, Rush University, Chicago, IL 60612, USA. audrey_french@rush.edu
Gawel
Susan H
SH
Hershow
Ronald
R
Benning
Lorie
L
Hessol
Nancy A
NA
Levine
Alexandra M
AM
Anastos
Kathryn
K
Augenbraun
Michael
M
Cohen
Mardge H
MH
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies