The recent declines in morbidity and mortality due to AIDS are attributable to the use of more intensive antiretroviral therapies.

Although overall death rates remained low through 2004, the proportion of deaths attributable to non-AIDS diseases increased and prominently included hepatic, cardiovascular, and pulmonary diseases, as well as non-AIDS malignancies. Longer time spent receiving HAART and higher CD4 cell counts at HAART initiation were associated with death from non-AIDS causes. CD4 cell count at time of death increased over time.

HIV-associated lipodystrophy is associated with several host, disease, and drug factors. While prevalence of lipoatrophy increased with the use of stavudine and indinavir, and lipoaccumulation was associated with duration of ART, other non-drug factors were strongly associated with both fat atrophy and accumulation.

No abstract

No abstract

Persons chronically infected with hepatitis C (HCV) may be at higher risk for developing and dying from non-liver as well as liver cancers than the general population. We therefore assessed cancer incidence and mortality among HCV-infected patients in four large health systems in the United States serving over 1.6 million adults, and compared with rates for the general population during the five-year period from 2006 to 2010. 12,126 chronic HCV-infected persons in the Chronic Hepatitis Cohort Study (CHeCS) contributed 39,984 person-years of follow-up from 2006 to 2010, and were compared to 133,795,010 records from 13 Surveillance, Epidemiology and End Results Program (SEER) cancer registries, and approximately 12 million US death certificates from Multiple Cause of Death (MCOD) data. Standardized rate ratios (SRR) and relative risk (RR) were calculated for incidence and mortality, respectively. The incidence of the following cancers was significantly higher among patients with chronic HCV infection: liver (SRR, 48.6 [95% CI, 44.4–52.7]), pancreas (2.5 [1.7–3.2]), rectum (2.1 [1.3–2.8]), kidney (1.7 [1.1–2.2]), non-Hodgkin lymphoma (1.6 [1.2–2.1]), and lung (1.6 [1.3–1.9]). Age-adjusted mortality was significantly higher among patients with: liver (RR, 29.6 [95% CI, 29.1–30.1]), oral (5.2 [5.1–5.4]), rectum (2.6 [2.5–2.7]), non-Hodgkin lymphoma (2.3 [2.2–2.31]), and pancreatic (1.63 [1.6–1.7]) cancers. The mean age of cancer diagnosis and cancer-related death was significantly younger in CHeCS HCV cohort patients compared to the general population for many cancers. Conclusions Incidence and mortality of many types of non-liver cancers were higher, and age at diagnosis and death younger, in patients with chronic HCV infection compared to the general population.

Baseline demographic, hospitalization, and mortality data from CHeCS highlight the substantial US health burden from chronic viral hepatitis, particularly among persons born during 1945-1964.

The rates of hospitalizations for HIV-infected patients declined substantially during 1994-2005, due mainly to reductions in the AIDS opportunistic infections. Compared with the period 1994-1997, patients in the highly active antiretroviral therapy era were hospitalized with higher CD4+ cell counts and more frequently for chronic end-organ conditions.