Serious fatal and nonfatal non-AIDS-defining illnesses in Europe.
BACKGROUND
Little is known about the incidence and risk factors for serious non-AIDS-defining events.


METHODS
The incidence of non-AIDS events (malignancies, end-stage renal disease, liver failure, pancreatitis, cardiovascular disease), and AIDS after January 1, 2001, was calculated; Poisson regression was used to investigate factors associated with non-AIDS and AIDS.


RESULTS
Among 12,844 patients, 1058 were diagnosed with a non-AIDS event [incidence 1.77 per 100 person-years of follow-up; 95% confidence interval (CI): 1.66 to 1.87]; 462 patients (43.7%) died. The incidence of AIDS (1025 diagnoses; 339 deaths, 33.1%) was 1.72 per 100 person-years of follow-up (1.61 to 1.83). After adjustment, older age [incidence rate ratio (IRR): 1.71 per 10 years older, 95% CI: 1.60 to 1.83], diabetes (IRR: 1.49, 95% CI: 1.22 to 1.82) and hypertension (IRR: 1.63, 95% CI: 1.43 to 1.87) were associated with non-AIDS events. Compared with patients without an event, there was a 4-fold increased risk of death after an AIDS event (relative hazard: 4.14; 95% CI 3.47 to 4.94) and almost a 7-fold increased risk of death after a non-AIDS event (relative hazard: 6.72; 95% CI: 5.61 to 8.05).


CONCLUSIONS
Non-AIDS events were common in the combination antiretroviral therapy era and associated with considerably mortality. Evidence on the impact of modifying immunodeficiency and lifestyle-related factors on the risk of non-AIDS events in HIV-infected persons is an important but unmet research need.
Mocroft
Amanda
A
Research Department of Infection and Population Health, University College Medical School, London, UK. a.mocroft@ucl.ac.uk
Reiss
Peter
P
Gasiorowski
Jacek
J
Ledergerber
Bruno
B
Kowalska
Justyna
J
Chiesi
Antonio
A
Gatell
Jose
J
Rakhmanova
Aza
A
Johnson
Margaret
M
Kirk
Ole
O
Lundgren
Jens
J
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000401:mortality; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active / Q000401:mortality; D018791:CD4 Lymphocyte Count; D004813:Epidemiology / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D009026:Mortality; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D012307:Risk Factors