Faculty Collaboration Database

Association of HIV infection, demographic and cardiovascular risk factors with all-cause mortality in the recent HAART era. J Acquir Immune Defic Syndr 2010 Jan;53(1):102-6

Date

09/10/2009

Pubmed ID

19738484

Pubmed Central ID

PMC2799541

DOI

10.1097/QAI.0b013e3181b79d22

Scopus ID

2-s2.0-74049107057 (requires institutional sign-in at Scopus site)   68 Citations

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.

Author List

Cockerham L, Scherzer R, Zolopa A, Rimland D, Lewis CE, Bacchetti P, Grunfeld C, Shlipak M, Tien PC

Author

Leslie Cockerham MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Cardiovascular Diseases
Cause of Death
Clinical Trials as Topic
Female
Follow-Up Studies
HIV Infections
HIV-1
Humans
Male
Multivariate Analysis
Regression Analysis
Risk Factors
Smoking
United States