Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013;8(4):e59768.
doi: 10.1371/journal.pone.0059768. Epub 2013 Apr 5.

Changing mortality profile among HIV-infected patients in Rio de Janeiro, Brazil: shifting from AIDS to non-AIDS related conditions in the HAART era

Beatriz Grinsztejn  1 , Paula M Luz, Antonio G Pacheco, Desiree V G Santos, Luciane Velasque, Ronaldo I Moreira, Maria Regina C Guimarães, Estevão P Nunes, Alberto S Lemos, Sayonara R Ribeiro, Dayse P Campos, Marco A A Vitoria, Valdilea G Veloso
Affiliations

Changing mortality profile among HIV-infected patients in Rio de Janeiro, Brazil: shifting from AIDS to non-AIDS related conditions in the HAART era

Beatriz Grinsztejn et al. PLoS One. 2013.

Abstract

Introduction: We describe temporal trends in the mortality rates and factors associated with AIDS and non-AIDS related mortality at the Evandro Chagas Clinical Research Institute (IPEC), Oswaldo Cruz Foundation (FIOCRUZ).

Methods: Adult patients enrolling from 1986 through 2009 with a minimum follow up of 60 days were included. Vital status was exhaustively checked using patients' medical charts, through active contact with individuals and family members and by linkage with the Rio de Janeiro Mortality database using a previously validated algorithm. The CoDe protocol was used to establish the cause of death. Extended Cox proportional hazards models were used for multivariate modeling.

Results: A total of 3530 individuals met the inclusion criteria, out of which 868 (24.6%) deceased; median follow up per patient was 3.9 years (interquartile range 1.7-9.2 years). The dramatic decrease in the overall mortality rates was driven by AIDS-related causes that decreased from 9.19 deaths/100PYs n 1986-1991 to 1.35/100PYs in 2007-2009. Non-AIDS related mortality rates remained stable overtime, at around 1 death/100PYs. Immunodeficiency significantly increased the hazard of both AIDS-related and non-AIDS-related causes of death, while HAART use was strongly associated with a lower hazard of death from either cause.

Conclusions: Our results confirm the remarkable decrease in AIDS-related mortality as the HIV epidemic evolved and alerts to the conditions not traditionally related to HIV/AIDS which are now becoming more frequent, needing careful monitoring.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Mortality rates and Cumulative Incidence Functions for AIDS-related, non-AIDS related and unknown causes of death.
Mortality rates for AIDS-related, non-AIDS related, and unknown causes of death over calendar periods (A) and Cumulative Incidence Functions for AIDS-related, non-AIDS related and unknown causes of death for the entire cohort (B) and for those enrolling from 1997 onwards (C).
See this image and copyright information in PMC

References

    1. ART-CC (2010) Causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996–2006: collaborative analysis of 13 HIV cohort studies. Clinical Infectious Diseases 50: 1387–1396. - PMC - PubMed
    1. Crum NF, Riffenburgh RH, Wegner S, Agan BK, Tasker SA, et al. (2006) Comparisons of causes of death and mortality rates among HIV-infected persons: analysis of the pre-, early, and late HAART (highly active antiretroviral therapy) eras. Journal of the Acquired Immunodeficiency Syndrome 41: 194–200. - PubMed
    1. Pacheco AG, Tuboi SH, Faulhaber JC, Harrison LH, Schechter M (2008) Increase in non-AIDS related conditions as causes of death among HIV-infected individuals in the HAART era in Brazil. PLoS One 3: e1531. - PMC - PubMed
    1. Pacheco AG, Tuboi SH, May SB, Moreira LF, Ramadas L, et al. (2009) Temporal changes in causes of death among HIV-infected patients in the HAART era in Rio de Janeiro, Brazil. Journal of the Acquired Immunodeficiency Syndrome 51: 624–630. - PMC - PubMed
    1. Grinsztejn B, Veloso VG, Friedman RK, Moreira RI, Luz PM, et al. (2009) Early mortality and cause of deaths in patients using HAART in Brazil and the United States. AIDS 23: 2107–2114. - PMC - PubMed

Publication types