title: Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010.
abstract: There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in care in the United States and Canada.
  
  
  
  We studied HIV-infected participants in 16 cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) during 2000-2010. After excluding 16 737 (21%) with any AIDS-defining clinical events documented before NA-ACCORD enrollment, we analyzed incident OIs among the remaining 63 541 persons, most of whom received antiretroviral therapy during the observation. We calculated incidence rates per 100 person-years of observation (hereafter, "person-years") with 95% confidence intervals (CIs) for the first occurrence of any OI and select individual OIs during 2000-2003, 2004-2007, and 2008-2010.
  
  
  
  A total of 63 541 persons contributed 261 573 person-years, of whom 5836 (9%) developed at least 1 OI. The incidence rate of any first OI decreased over the 3 observation periods, with 3.0 cases, 2.4 cases, and 1.5 cases per 100 person-years of observation during 2000-2003, 2004-2007, and 2008-2010, respectively (Ptrend<.001); the rates of most individual OIs decreased as well. During 2008-2010, the leading OIs included Pneumocystis jiroveci pneumonia, esophageal candidiasis, and disseminated Mycobacterium avium complex or Mycobacterium kansasii infection.
  
  
  
  For HIV-infected persons in care during 2000-2010, rates of first OI were relatively low and generally declined over this time.
authors: Divisions of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Kate
authors: K
authors: Buchacz
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Bryan
authors: B
authors: Lau
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Yuezhou
authors: Y
authors: Jing
authors: Harvard University, Boston, Massachusetts.
authors: Ronald
authors: R
authors: Bosch
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Alison G
authors: AG
authors: Abraham
authors: University of Calgary, Alberta, Canada.
authors: M John
authors: MJ
authors: Gill
authors: Kaiser Permanente Northern California, Oakland.
authors: Michael J
authors: MJ
authors: Silverberg
authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
authors: James J
authors: JJ
authors: Goedert
authors: Vanderbilt University Medical Center, Nashville, Tennessee.
authors: Timothy R
authors: TR
authors: Sterling
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Keri N
authors: KN
authors: Althoff
authors: University of California-San Francisco.
authors: Jeffrey N
authors: JN
authors: Martin
authors: University of Alabama at Birmingham.
authors: Greer
authors: G
authors: Burkholder
authors: Emory University, Atlanta, Georgia.
authors: Neel
authors: N
authors: Gandhi
authors: Johns Hopkins University, Baltimore, Maryland British Columbia Centre for Excellence in HIV/AIDS, Vancouver.
authors: Hasina
authors: H
authors: Samji
authors: Divisions of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Pragna
authors: P
authors: Patel
authors: University of Toronto, Ontario, Canada.
authors: Anita
authors: A
authors: Rachlis
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Jennifer E
authors: JE
authors: Thorne
authors: University of North Carolina at Chapel Hill.
authors: Sonia
authors: S
authors: Napravnik
authors: Hennepin County Medical Center, Minneapolis, Minnesota.
authors: Keith
authors: K
authors: Henry
authors: Universidad Central del Caribe, Puerto Rico.
authors: Angel
authors: A
authors: Mayor
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Kelly
authors: K
authors: Gebo
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Stephen J
authors: SJ
authors: Gange
authors: Johns Hopkins University, Baltimore, Maryland.
authors: Richard D
authors: RD
authors: Moore
authors: Divisions of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: John T
authors: JT
authors: Brooks
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
keywords: AIDS-related opportunistic infections; CD4+ T-lymphocyte count; HIV cohort studies; combination antiretroviral therapy; epidemiology; incidence; prophylaxis