Muertes por enfermedades no asociadas directamente con el sida en pacientes con infección por el VIH: un estudio de 14 años (1998-2011)

López, Carlos Rosales; Masiá, Mar; Padilla, Sergio; Aquilino, Ana; Bas, Cristina; Gutiérrez, Félix

doi:10.1016/j.eimc.2015.04.010

Cited by 17 publications

(3 citation statements)

References 24 publications

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“…In this setting, quantifying and monitoring cancer mortality trends in PLWH are essential to understand its evolution and the underlying risk factors with the final aim of highlighting targeted priorities in care and prevention. In Spain, NADC mortality was three times higher among PLWH than the general population during the years 1999–2006 (Aldaz et al 2011 ), but data on recent mortality trends over time are lacking or only limited to the regional level (López et al 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up

Suárez-García,

Gutierrez,

Pérez-Molina

et al. 2023

J Cancer Res Clin Oncol

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Purpose Our aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors. Methods We included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004–2021). We estimated mortality rates and standardised mortality ratios (SMRs). We used cause-specific Cox models to identify risk factors. Results Among 17,978 PLWH, NADC caused 21% of all deaths observed during the follow-up. Mortality rate due to NADC was 1.58 (95%CI 1.36, 1.83) × 1000 person-years and lung and liver were the most frequent cancer-related causes of death. PLWH had 79% excess NADC mortality risk compared to the general population with the highest SMR found for Hodgkin lymphoma, anal and liver cancers. The SMRs decreased with age and were the highest in age groups under 50 years. The most important prognostic factor was low CD4 count, followed by smoking, viral hepatitis and HIV transmission through heterosexual contact or injection drug use. Conclusion Non-AIDS cancers are an important cause of death among PLWH. The excess mortality related to certain malignancies and the association with immunodeficiency, smoking, and coinfections highlights the need for early detection and treatment of cancer in this population.

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Section: Introductionmentioning

confidence: 99%

Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up

Suárez-García,

Gutierrez,

Pérez-Molina

et al. 2023

J Cancer Res Clin Oncol

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“…The current analysis and research on HIV-infected populations usually target all HIV-infected populations in some certain areas [19]. The research contents mainly focuses on the mortality [20][21][22], the incidence of certain AD [20,23] and NAD [14][15][16][17][18][24][25][26][27][28][29][30][31], the mechanism [32] and strategies [7,33] of the aging and frailty in PLWH, but there is no comprehensive analysis and predictive research on ILWH. Therefore, we have established the LSTNet deep learning framework to predict the changes of ILWH in the next 10 years.…”

Section: Introductionmentioning

confidence: 99%

Changes And Future Challenges In The Disease Burden of Inpatients Living With HIV In China: A Predictive Study Based On Retrospective Cohort Data

Shuai¹,

Nie²,

Huang³

et al. 2021

Preprint

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Objective: In China, the widespread use of Combination Antiretroviral Therapy (cART) has significantly improved the prognosis and quality of life in people living with HIV(PLWH). However, some PLWH still got worse and were hospitalized for some reasons, including AIDS-Defining Diseases(AD, such as opportunistic infections and AIDS-related Malignancies), Non-AIDS-Defining Diseases (NAD, such as non-AIDS-defining Malignancies and metabolic syndrome). At present, the age and disease of inpatients living with HIV(ILWH) are undergoing some significant changes. For example, the average age of ILWH is gradually increasing, the proportions of ILWH with NAD in all age groups are increasing, and the proportion of ILWH suffering from multiple types of NAD is increasing, which will have a greater impact to both ILWH and infectious disease hospitals. We aim to predict the changes in ILWH in the next 10 years, analyze the impact of such changes on ILWH and infectious disease hospitals in China, and propose corresponding countermeasures.Methods: Based on the 12618 data of ILWH admitted to Chongqing Public Health Medical Center during 2010-2020, We have established a long- and short-term time-series network (LSTNet) deep learning framework based on the Convolution Neural Network (CNN) and the Recurrent Neural Network (RNN). By the framework, we have predicted the age, the proportion of AD and NAD , the proportion of multiple NADs, and the proportion of NAD occurrences in ILWH up to 2030 .Results: Our model showed that the average age of ILWH has risen from 43.8 years in 2010 to 57.6 years in 2030, and the increase in the age of women is greater than that of men. The number of ILWH in different age groups has changed significantly. Among them, the proportion of ILWH under 50 years old has gradually decreased, and the proportion of ILWH over 50 years old has gradually raised. By 2030, the proportion of ILWH over 50 years old will be close to 80%. The proportion of fatal opportunistic infections among ILWH has decreased year by year, and the most common diseases are tuberculosis-related diseases. The proportions of ILWH with only AD or NAD have gradually decreased, and the proportion of ILWH with both AD and NAD has increased year by year. It is estimated that the proportion of all ILWH with both AD and NAD will exceed 80% by 2030. Among all kinds of diseases in NAD, metabolic syndrome will have the highest rate of increase. By 2030, it will account for 16% in all ILWH. The proportion of hepatobiliary and pancreatic system diseases and blood system diseases in NAD will gradually decrease, while the proportion of metabolic syndrome, kidney disease, gastrointestinal disease, non-AIDS defining malignancies(NADM), bone disease and neurological diseases in NAD will gradually increase. The proportion of ILWH with NAD in all age groups will increase significantly after 10 years. Among them, the proportion of ILWH with NAD in 50-60 years old will be more than 80%, and among the ILWH under 30 years old, the proportion of ILWH suffering from NAD will increase to 69.6%. The proportion of ILWH without NAD or only 1 NAD will decrease, while the proportion of ILWH with 3 or more NAD will rise sharply. The proportion of ILWH with 1 type of NAD will drop to 12.6%, while the proportion of ILWH with 2 types of NAD, and the proportion of ILWH with 3 or more types of NAD will increase greatly.Conclusions: Significant changes have took place in the disease burden of ILWH in China, including the aging, the increase in the proportion of ILWH with NAD, and the increase in the proportion of ILWH with multiple types of NAD. These changes mean that in the next 10 years, the diagnosis, treatment and care of ILWH, as well as the development and construction of infectious disease hospitals will all face new challenges. This finding is based on a large number of long-term ILWH data in Chongqing, China, so we can consider that our research strategy can be promoted in China to improve the cure rate and quality of life in ILWH.

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“…O início da TARV eficaz a partir de 1996 levou a um rápido declínio na incidência de neoplasias definidoras de aids, principalmente sarcoma de Kaposi e linfoma não-Hodgkin 58 . Tal diminuição, no entanto, foi acompanhada por um aumento na incidência de outras neoplasias, de tal magnitude que, atualmente, um terço das mortes em PVH está relacionada a câncer 59,60 .…”

Section: Neoplasiasunclassified

Preditores de resposta sustentada a terapia antirretroviral em pessoas vivendo com HIV com mais de 50 anos de idade acompanhadas no ambulatório de HIV/aids do Hospital das Clínicas da Universidade Estadual de Campinas

Salvador¹

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A ata de defesa com as respectivas assinaturas dos membros da banca examinadora encontra-se no processo de vida acadêmica do aluno.Data: 31/08/2018 RESUMO Uma proporção crescente de pessoas vivendo com HIV (PVH) tem mais de 50 anos. Idade avançada modifica o curso da infecção pelo HIV e tem sido associada a resposta imune menos eficaz e alta morbimortalidade após o início da terapia anti-retroviral (TARV).Nós visamos identificar fatores associados à resposta satisfatória da TARV em uma coorte de pacientes com idade de 50 anos ou mais em acompanhamento de longo prazo em um ambulatório no Brasil. Neste estudo retrospectivo, incluímos pacientes em cuidados crônicos que apresentaram pelo menos uma consulta entre setembro de 2016 e fevereiro de 2018. Os dados foram coletados de forma padronizada, e as associações entre "resposta ART" e fatores preditivos foram explorado por análise univariada e multivariada. Entre 333 pacientes, 63,4% eram homens, mais comumente infectados por via sexual heterossexual (70.8% dos homens 91.3% das mulheres. A mediana de idade ao diagnóstico foi de 42 anos, tempo desde o diagnóstico 16,2 anos, e duração total da TARV 14,8 anos. Doença avançada foi predominante: 72,4% tinham AIDS e o nadir mediano de CD4 era de 138 células / mm³. Em dados coletados da visita mais recente 91% dos pacientes tinham carga viral <200 c / mL com uma duração mediana de supressão viral de 8,9 anos. Contagens de CD4> 350 células / mm³ foram alcançados por 85,7% dos indivíduos. Encontramos uma taxa alta (80%) de resposta satisfatória a longo prazo à TAR, fortemente previsto pelo nadir CD4, tempo de tratamento, duração da supressão viral e malignidade. Em conclusão, diagnóstico e tratamento precoces, mas não a idade, juntamente com a alta adesão do paciente ao tratamento são críticos para garantir a recuperação imunológica completa. PVH permanecem vulneráveis a neoplasias nãoaids e seus efeitos na resposta à TARV.

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Muertes por enfermedades no asociadas directamente con el sida en pacientes con infección por el VIH: un estudio de 14 años (1998-2011)

Cited by 17 publications

References 24 publications

Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up

Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up

Changes And Future Challenges In The Disease Burden of Inpatients Living With HIV In China: A Predictive Study Based On Retrospective Cohort Data

Preditores de resposta sustentada a terapia antirretroviral em pessoas vivendo com HIV com mais de 50 anos de idade acompanhadas no ambulatório de HIV/aids do Hospital das Clínicas da Universidade Estadual de Campinas

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