OBJECTIVE: To determine mortality due to end-stage liver disease (ESLD) in a nationwide cohort of HIV-infected patients 5 years after the introduction of highly active antretroviral therapy (HAART) and to compare this with that observed before and during the early years of HAART. DESIGN: and methods: All departments of internal medicine and infectious diseases from the GERMIVIC Study Group prospectively recorded all deaths in HIV-infected patients during 2001. Sixty-five departments, following a total of 25 178 HIV-infected patients, participated in the study. Results were compared with those of previous surveys conducted using similar methodology in 1995 and 1997. RESULTS: Among 265 deaths observed during 2001, 129 (48.7%) were related to AIDS, 38 (14.3%) to ESLD, and 98 (36.7%) to other causes. Mortality due to ESLD represented 28% of non AIDS-related deaths; 36 of the 38 patients (95%) dying from ESLD had chronic hepatitis C virus (HCV) infection. In 2001, deaths due to ESLD (14.3%) were significantly more frequent than in 1995 (1.5%; P < 0.01) and 1997 (6.6%; P < 0.01). During this interval, the prevalence of hepatocellular carcinoma as a cause of death increased (1995, 4.7%; 1997, 11%; 2001, 25%; P < 0.05), as did alcohol consumption (P < 0.01). CONCLUSIONS: In the post-HAART era, ESLD due to HCV is a growing cause of mortality in HIV-infected patients. Increased longevity attributable to HAART, and a higher prevalence of alcohol consumption, are probably involved in this trend.
OBJECTIVE: To determine mortality due to end-stage liver disease (ESLD) in a nationwide cohort of HIV-infectedpatients 5 years after the introduction of highly active antretroviral therapy (HAART) and to compare this with that observed before and during the early years of HAART. DESIGN: and methods: All departments of internal medicine and infectious diseases from the GERMIVIC Study Group prospectively recorded all deaths in HIV-infectedpatients during 2001. Sixty-five departments, following a total of 25 178 HIV-infectedpatients, participated in the study. Results were compared with those of previous surveys conducted using similar methodology in 1995 and 1997. RESULTS: Among 265 deaths observed during 2001, 129 (48.7%) were related to AIDS, 38 (14.3%) to ESLD, and 98 (36.7%) to other causes. Mortality due to ESLD represented 28% of non AIDS-related deaths; 36 of the 38 patients (95%) dying from ESLD had chronic hepatitis C virus (HCV) infection. In 2001, deaths due to ESLD (14.3%) were significantly more frequent than in 1995 (1.5%; P < 0.01) and 1997 (6.6%; P < 0.01). During this interval, the prevalence of hepatocellular carcinoma as a cause of death increased (1995, 4.7%; 1997, 11%; 2001, 25%; P < 0.05), as did alcohol consumption (P < 0.01). CONCLUSIONS: In the post-HAART era, ESLD due to HCV is a growing cause of mortality in HIV-infectedpatients. Increased longevity attributable to HAART, and a higher prevalence of alcohol consumption, are probably involved in this trend.
Authors: John F Deeken; Angelique Tjen-A-Looi; Michelle A Rudek; Catherine Okuliar; Mary Young; Richard F Little; Bruce J Dezube Journal: Clin Infect Dis Date: 2012-07-09 Impact factor: 9.079
Authors: Monica A Konerman; Shruti H Mehta; Catherine G Sutcliffe; Trang Vu; Yvonne Higgins; Michael S Torbenson; Richard D Moore; David L Thomas; Mark S Sulkowski Journal: Hepatology Date: 2014-01-16 Impact factor: 17.425