Universität zu Köln

Trickey, Adam, van Sighem, Ard, Stover, John, Abgrall, Sophie, Grabar, Sophie, Bonnet, Fabrice, Berenguer, Juan, Wyen, Christoph, Casabona, Jordi, Monforte, Antonella d'Arminio, Cavassini, Matthias, del Amo, Julia, Zangerle, Robert, Gill, M. John, Obel, Niels, Sterne, Jonathan A. C. and May, Margaret T. (2019). Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings. Aids, 33. S. S271 - 11. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-5571

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Abstract

Introduction: HIV cohort data from high-income European countries were compared with the UNAIDS Spectrum modelling parameters for these same countries to validate mortality rates and excess mortality estimates for people living with HIV (PLHIV) on antiretroviral therapy (ART). Methods: Data from 2000 to 2015 were analysed from the Antiretroviral Therapy Cohort Collaboration (ART-CC) for Austria, Denmark, France, Italy, the Netherlands, Spain, and Switzerland. Flexible parametric models were used to compare all-cause mortality rates in the ART-CC and Spectrum. The percentage of AIDS-related deaths and excess mortality (both are the same within Spectrum) were compared, with excess mortality defined as that in excess of the general population mortality. Results: Analyses included 94 026 PLHIV with 585 784 person-years of follow-up, from which there were 5515 deaths. All-cause annual mortality rates in Spectrum for 2000-2003 were 0.0121, reducing to 0.0078 in 2012-2015, whilst the ART-CC's corresponding annual mortality rates were 0.0151 [95% confidence interval (95% CI): 0.0130-0.0171] reducing to 0.0049 (95% CI: 0.0039-0.0060). The percentage of AIDS-related deaths in Spectrum was 74.7% in 2000-2003, dropping to 43.6% in 2012-2015. In the ART-CC, AIDS-related mortality constitutes 45.3% (95% CI: 38.4-52.9%) of mortality in 2000-2003 and 26.7% (95% CI: 19-46%) between 2012 and 2015. Excess mortality in the ART-CC was broadly similar to the Spectrum estimates, dropping from 75.3% (95% CI: 60.3-95.2%) in 2000-2003 to 30.7% (95% CI: 25.5-63.7%) in 2012-2015. Conclusion: All-cause mortality assumptions for PLHIV on ART in high-income European settings should be adjusted in Spectrum to be higher in 2000-2003 and decline more quickly to levels currently captured for recent years.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Trickey, Adam UNSPECIFIED UNSPECIFIED UNSPECIFIED van Sighem, Ard UNSPECIFIED UNSPECIFIED UNSPECIFIED Stover, John UNSPECIFIED UNSPECIFIED UNSPECIFIED Abgrall, Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED Grabar, Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonnet, Fabrice UNSPECIFIED UNSPECIFIED UNSPECIFIED Berenguer, Juan UNSPECIFIED UNSPECIFIED UNSPECIFIED Wyen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Casabona, Jordi UNSPECIFIED UNSPECIFIED UNSPECIFIED Monforte, Antonella d'Arminio UNSPECIFIED UNSPECIFIED UNSPECIFIED Cavassini, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED del Amo, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Zangerle, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Gill, M. John UNSPECIFIED UNSPECIFIED UNSPECIFIED Obel, Niels UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterne, Jonathan A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED May, Margaret T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-124343
DOI:	10.1097/QAD.0000000000002387
Journal or Publication Title:	Aids
Volume:	33
Page Range:	S. S271 - 11
Date:	2019
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-5571
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HIV-POSITIVE PATIENTS; COHORT COLLABORATION; INFECTED ADULTS; DEATH; PEOPLE; SURVIVAL; PROFILE Multiple languages Immunology; Infectious Diseases; Virology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12434