Serious fatal and nonfatal non-AIDS-defining illnesses in Europe

J Acquir Immune Defic Syndr. 2010 Oct;55(2):262-70. doi: 10.1097/QAI.0b013e3181e9be6b.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Acquired Immunodeficiency Syndrome / mortality
  • Age Factors
  • Antiretroviral Therapy, Highly Active / mortality
  • CD4 Lymphocyte Count
  • Epidemiology / statistics & numerical data
  • Europe / epidemiology
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Mortality
  • Poisson Distribution
  • Proportional Hazards Models
  • Risk Factors