TY - JOUR
T1 - Liver-related deaths in persons infected with the human immunodeficiency virus
T2 - The D:A:D Study
AU - Collins, S.
AU - Mertenskoetter, T.
AU - Loeliger, E.
AU - Tressler, R.
AU - Weller, I.
AU - Friis-Møller, N.
AU - Worm, S. W.
AU - Sabin, C. A.
AU - Sjøl, A.
AU - Lundgren, J. D.
AU - Sawitz, A.
AU - Rickenbach, M.
AU - Pezzotti, P.
AU - Krum, E.
AU - Gras, L.
AU - Balestre, E.
AU - Sundström, A.
AU - Poll, B.
AU - Fontas, E.
AU - Torres, F.
AU - Petoumenos, K.
AU - Kjær, J.
AU - Weber, Rainer
AU - Sabin, Caroline A.
AU - Friis-Møller, Nina
AU - Reisswafaamel-Sadr, Peter
AU - Kirk, Ole
AU - Dabis, Francois
AU - Law, Matthew G.
AU - Pradier, Christian
AU - De Wit, Stephane
AU - Akerlund, Börje
AU - Calvo, Gonzalo
AU - Monforte, Antonella D.Arminio
AU - Rickenbach, Martin
AU - Ledergerber, Bruno
AU - Phillips, Andrew N.
AU - Lundgren, Jens D.
AU - De Wolf, F.
AU - Zaheri, S.
AU - Gras, L.
AU - Bronsveld, W.
AU - Hillebrand-Haverkort, M. E.
AU - Prins, J. M.
AU - Bos, J. C.
AU - Schattenkerk, J. K.M.Eeftinck
AU - Geerlings, S. E.
AU - Godfried, M. H.
AU - Lange, J. M.A.
AU - Neaton, J.
AU - The Data Collection on Adverse Events of Anti-HIV Drugs Study Group
PY - 2006/8/28
Y1 - 2006/8/28
N2 - Background: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. Methods: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow- up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. Results: There were 1246 deaths (5.3%; 1.6 per 100 person- years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis coinfections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for <50 vs >500/ μL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P=.008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P=.02). Conclusions: Liver-related death was the most frequent cause of non-AIDS-related death.Wefound a strong association between immunodeficiency and risk of liverrelated death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.
AB - Background: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. Methods: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow- up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. Results: There were 1246 deaths (5.3%; 1.6 per 100 person- years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis coinfections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for <50 vs >500/ μL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P=.008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P=.02). Conclusions: Liver-related death was the most frequent cause of non-AIDS-related death.Wefound a strong association between immunodeficiency and risk of liverrelated death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.
UR - http://www.scopus.com/inward/record.url?scp=33747189450&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747189450&partnerID=8YFLogxK
U2 - 10.1001/archinte.166.15.1632
DO - 10.1001/archinte.166.15.1632
M3 - Article
C2 - 16908797
SN - 0003-9926
VL - 166
SP - 1632
EP - 1641
JO - Archives of Internal Medicine
JF - Archives of Internal Medicine
IS - 15
ER -
