title: Causes of death and risk factors for mortality among HIV-infected patients receiving antiretroviral therapy in Korea.
abstract: A retrospective study was conducted to determine the mortality, causes and risk factors for death among HIV-infected patients receiving antiretroviral therapy (ART) in Korea. The outcomes were determined by time periods, during the first year of ART and during 1-5 yr after ART initiation, respectively. Patients lost to follow-up were traced to ascertain survival status. Among 327 patients initiating ART during 1998-2006, 68 patients (20.8%) died during 5-yr follow-up periods. Mortality rate per 100 person-years was 8.69 (95% confidence interval, 5.68-12.73) during the first year of ART, which was higher than 4.13 (95% confidence interval, 2.98-5.59) during 1-5 yr after ART. Tuberculosis was the most common cause of death in both periods (30.8% within the first year of ART and 16.7% during 1-5 yr after ART). During the first year of ART, clinical category B and C at ART initiation, and underlying malignancy were significant risk factors for mortality. Between 1 and 5 yr after ART initiation, CD4 cell count ≤ 50 cells/µL at ART initiation, hepatitis B virus co-infection, and visit constancy ≤ 50% were significant risk factors for death. This suggests that different strategies to reduce mortality according to the time period after ART initiation are needed.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea. zzanmery@gmail.com
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Kye-Hyung
authors.initials: KH
authors.lastname: Kim
authors.forename: Seung Geun
authors.initials: SG
authors.lastname: Lee
authors.forename: Heerim
authors.initials: H
authors.lastname: Cho
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Chen
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Chung
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
authors.forename: Goon Jae
authors.initials: GJ
authors.lastname: Cho
mesh_terms: D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D002423:Cause of Death; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D044966:Anti-Retroviral Agents
keywords: Antiretroviral Therapy; Cause of Death; HIV; Loss to Follow-up; Mortality; Retention in Care; Risk Factors; Visit Constancy