The heterogeneity of causes of death among HIV-infected adults was confirmed and intensified in 2005, with 3 causes following AIDS: cancers and liver-related and cardiovascular diseases.

In this study, an increasing proportion of lethal non-AIDS-related cancers was demonstrated from 2000 to 2005; meanwhile, the proportion of lethal AIDS-related cancers remained stable among HIV-infected patients. Thus, cancer prophylaxis, early diagnosis, and improved management should be included in the routine long-term follow-up of HIV-infected patients.

BackgroundMore than 10 years after the introduction of combination antiretroviral therapy (cART), we examined the trend in the proportion of deaths caused by end-stage liver disease (ESLD) in HIVinfected adults in France between 1995 and 2005. Design and methodsIn 2005, 34 departments prospectively recorded all deaths in HIV-infected patients who were followed in those departments (around 24 000). Results were compared with those of four previous cross-sectional surveys conducted since 1995 using the same methodology. ResultsAmong 287 reported deaths in 2005, 100 (35%) were related to AIDS, and 48 (17%) to ESLD. Three out of four patients who died from ESLD-related causes had chronic hepatitis C. Excessive alcohol consumption was reported in approximately half of the patients (48%). At death, 62% of patients had undetectable HIV viral load and the median CD4 count was 237 cells/mL. From 1995 to 2005, the proportion of deaths caused by ESLD increased from 2 to 17% (Po0.001). The proportion of deaths caused by hepatocellular carcinoma increased from 5% in 1995 to 25% in 2005 (P 5 0.0337). ConclusionsOver the 10 years from 1995 to 2005, the proportion of deaths caused by hepatitis C virus-related ESLD has increased in HIV-infected patients. ESLD is currently a leading cause of death in this population, with hepatocellular carcinoma representing a quarter of liver-related deaths. Recommendations for the detection of hepatocellular carcinoma should be strictly applied in these patients.Keywords: cirrhosis, hepatitis C virus, hepatocellular carcinoma, HIV, morbidity, mortality IntroductionThe widespread use of combination antiretroviral therapy (cART) in northern countries has increased life expectancy among individuals infected with HIV. The primary reason for this increased longevity is the decreasing rate of opportunistic infections which have often been a direct cause of death. Studies from single institutions have shown that liver disease caused by chronic hepatitis C virus (HCV) infection has become a significant cause of mortality among coinfected patients [1][2][3][4]. However, few studies have addressed the trends in mortality caused by HCV infection over a long period of time.In the last several years, the proportion of deaths caused by end-stage liver disease (ESLD) in French HIV-infected patients has progressively increased with time, and ESLD has become a leading cause of mortality [5][6][7]. This is likely to be related to prolonged longevity as a result of decreasing AIDS-related mortality, prolonged exposure to chronic HCV infection and high alcohol consumption. In parallel, large trials have demonstrated that HIV/HCVcoinfected patients may achieve a sustained virological response on combined treatment with pegylated interferon plus ribavirin, leading to histopathological improvement [8,9]. In daily clinical practice, continuing efforts to educate physicians and patients have increased access of HIV/HCV-coinfected patients to HCV treatment [10,11].In light of the critical role of time in the progressi...

word count: 197Text word count: 3334 (abstract excluded)Figures: 2 Tables: 3 ABSTRACT: Background. Longer exposure to hepatitis C (HCV) or B virus (HBV) and the increased use of

Tolerability of the combination of zidovudine-lamivudine and lopinavir-ritonavir as postexposure prophylaxis (PEP) for human immunodeficiency virus infection was prospectively assessed. A total of 121 patients were enrolled in the study; 23 patients discontinued PEP prematurely for reasons other than adverse events. Of the other 98 patients, 58 (59%) experienced adverse effects, which led to premature PEP discontinuation in 20 cases (20%).