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. 2010 Jan;53(1):102-6.
doi: 10.1097/QAI.0b013e3181b79d22.

Association of HIV infection, demographic and cardiovascular risk factors with all-cause mortality in the recent HAART era

Leslie Cockerham  1 , Rebecca Scherzer, Andrew Zolopa, David Rimland, Cora E Lewis, Peter Bacchetti, Carl Grunfeld, Michael Shlipak, Phyllis C Tien
Affiliations

Association of HIV infection, demographic and cardiovascular risk factors with all-cause mortality in the recent HAART era

Leslie Cockerham et al. J Acquir Immune Defic Syndr. 2010 Jan.

Abstract

Objective: To determine the relationship of HIV infection, demographic, and cardiovascular disease (CVD) risk factors with mortality in the recent highly active antiretroviral therapy era.

Methods: Vital status was ascertained from 2004 to 2007 in 922 HIV infected and 280 controls in the Study of Fat Redistribution and Metabolic Change in HIV infection; 469 HIV infected were included in analysis comparing HIV with similar age controls. Multivariable exponential survival regression (adjusting for demographic and CVD factors) estimated hazard ratios (HRs) for death.

Results: After 5 years of follow-up, the overall adjusted mortality HR was 3.4 [95% confidence interval (CI): 1.35-8.5]; HR was 6.3 among HIV infected with CD4 < 200 (95% CI: 2.2-18.2), 4.3 with CD4 200-350 (95% CI: 1.14-16.0), and 2.3 with CD4 > 350 (95% CI: 0.78-6.9). Among HIV infected, current smoking (HR = 2.73 vs. never smokers, 95% CI: 1.64-4.5) and older age (HR = 1.61 per decade, 95% CI: 1.27-2.1) were independent risk factors for death; higher baseline CD4 count was associated with lower risk (HR = 0.65 per CD4 doubling, 95% CI: 0.58-0.73).

Conclusions: HIV infection was associated with a 3-fold mortality risk compared with controls after adjustment for demographic and CVD risk factors. In addition to low baseline CD4 count, older age and current smoking were strong and independent predictors of mortality in a US cohort of HIV-infected participants in clinical care.

Trial registration: ClinicalTrials.gov NCT00331448.

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Conflict of interest statement

Conflicts of Interest: None

Figures

FIGURE 1
FIGURE 1
Schema of results of FRAM 2 Retention
FIGURE 2
FIGURE 2
Association of HIV status and baseline CD4 count with mortality after adjustment for demographic and CVD risk factors
See this image and copyright information in PMC

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