BACKGROUND: HAART has reduced mortality in HIV-infected patients; however, the risk of non-AIDS-related events has increased, including cancer. We compared mortality in HIV-infected patients with or without cancer with the general population in Italy. METHODS: Eligible patients were recorded in the San Raffaele Infectious Diseases Department database. The ratio of observed deaths to expected all-cause deaths (standardized mortality ratio [SMR]) was standardized for age and gender, and stratified by cancer occurrence or year of HIV infection (≤1998 or >1998). Expected all-cause deaths were obtained from the Istituto Superiore di Sanità (Rome, Italy; 2002 data). RESULTS: Among 6,495 HIV-infected patients, contributing 75,171 person-years, the SMR was 6.0 (95% CI 5.7, 6.4); SMRs decreased as age increased. Mortality rates were significantly higher than the general population for patients with or without cancer (SMR=15.1 [95% CI 13.6, 16.7] and 4.8 [95% CI 4.5, 5.1], respectively). For patients with or without cancer, SMRs were higher in those aged <45 years than older patients. SMRs for patients with cancer were almost stable in those infected with HIV ≤1998 (15.3; 95% CI 13.7, 17.0) or >1998 (13.5; 95% CI 9.2, 19.1). Among patients with cancer diagnosed with HIV >1998, age-adjusted SMRs ranged from 216.0 (95% CI 43.4, 631.3) to 6.8 (95% CI 4.7, 9.7) in patients <30 years or ≥70 years, respectively. CONCLUSIONS: Mortality in HIV-infected patients remains higher than the general population in Italy, with marked differences according to age, and cancer contributing to an increased excess of mortality.
BACKGROUND: HAART has reduced mortality in HIV-infectedpatients; however, the risk of non-AIDS-related events has increased, including cancer. We compared mortality in HIV-infectedpatients with or without cancer with the general population in Italy. METHODS: Eligible patients were recorded in the San Raffaele Infectious Diseases Department database. The ratio of observed deaths to expected all-cause deaths (standardized mortality ratio [SMR]) was standardized for age and gender, and stratified by cancer occurrence or year of HIV infection (≤1998 or >1998). Expected all-cause deaths were obtained from the Istituto Superiore di Sanità (Rome, Italy; 2002 data). RESULTS: Among 6,495 HIV-infectedpatients, contributing 75,171 person-years, the SMR was 6.0 (95% CI 5.7, 6.4); SMRs decreased as age increased. Mortality rates were significantly higher than the general population for patients with or without cancer (SMR=15.1 [95% CI 13.6, 16.7] and 4.8 [95% CI 4.5, 5.1], respectively). For patients with or without cancer, SMRs were higher in those aged <45 years than older patients. SMRs for patients with cancer were almost stable in those infected with HIV ≤1998 (15.3; 95% CI 13.7, 17.0) or >1998 (13.5; 95% CI 9.2, 19.1). Among patients with cancer diagnosed with HIV >1998, age-adjusted SMRs ranged from 216.0 (95% CI 43.4, 631.3) to 6.8 (95% CI 4.7, 9.7) in patients <30 years or ≥70 years, respectively. CONCLUSIONS: Mortality in HIV-infectedpatients remains higher than the general population in Italy, with marked differences according to age, and cancer contributing to an increased excess of mortality.
Authors: Daria Gotti; Elena Raffetti; Laura Albini; Laura Sighinolfi; Franco Maggiolo; Elisa Di Filippo; Nicoletta Ladisa; Gioacchino Angarano; Giuseppe Lapadula; Angelo Pan; Anna Degli Esposti; Massimiliano Fabbiani; Emanuele Focà; Alfredo Scalzini; Francesco Donato; Eugenia Quiros-Roldan Journal: PLoS One Date: 2014-04-23 Impact factor: 3.240
Authors: Suzanne M Ingle; Margaret T May; M John Gill; Michael J Mugavero; Charlotte Lewden; Sophie Abgrall; Gerd Fätkenheuer; Peter Reiss; Michael S Saag; Christian Manzardo; Sophie Grabar; Mathias Bruyand; David Moore; Amanda Mocroft; Timothy R Sterling; Antonella D'Arminio Monforte; Victoria Hernando; Ramon Teira; Jodie Guest; Matthias Cavassini; Heidi M Crane; Jonathan A C Sterne Journal: Clin Infect Dis Date: 2014-04-24 Impact factor: 9.079