Sex stratification of the trends and risk of mortality among individuals living with HIV under different transmission categories

Lee, Chun-Yuan; Lin, Yi-Pei; Tu, Hung-Pin; Wang, Sheng-Fan; Lu, Po‐Liang

doi:10.1038/s41598-022-13294-y

Cited by 3 publications

(2 citation statements)

References 51 publications

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“…Regarding HIV transmission risk groups, the higher risk of mortality among PWID has been widely reported [ 31 ]. The elevated risks observed in heterosexuals are similar to findings from a study that assessed all-cause mortality under different transmission categories [ 32 ]. Furthermore, the increased risk of mortality among PLWH with CD4 counts <350 cells/µL at cohort entry highlights the urgent need to address the unacceptably high rates of late HIV diagnosis, given its detrimental health impact, including increased mortality.…”

Section: Discussionsupporting

confidence: 81%

Evolving AIDS- and non-AIDS Mortality and Predictors in the PISCIS Cohort of People Living With HIV in Catalonia and the Balearic Islands (Spain), 1998–2020

Nomah,

Jamarkattel,

Bruguera

et al. 2024

Open Forum Infectious Diseases

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Background Effective antiretroviral therapy (ART) has substantially reduced AIDS-related deaths, shifting the focus to non-AIDS conditions in people living with HIV (PLWH). We examined mortality trends and predictors of AIDS- and non-AIDS mortality in the PISCIS cohort of PLWH in Catalonia and the Balearic Islands, Spain, from 1998 to 2020. Methods We used a modified CoDe protocol which has been widely adopted by various HIV cohorts to classify mortality causes. We applied standardised mortality rates (SMR) to compare with the general population and used competing risks models to determine AIDS-related and non-AIDS-related mortality predictors. Results Among 30,394 PLWH (81.5% male, median age at death 47.3), crude mortality was 14.2 per 1,000 person-years. All-cause SMR dropped from 9.6 (95%CI 8.45-10.90) in 1998-2003 to 3.33 (95%CI 3.14-3.53) in 2015-2020, p for trend=0.0001. Major causes were AIDS, non-AIDS cancers, cardiovascular disease, AIDS-defining cancers, viral hepatitis, and non-hepatitis liver disease. Predictors for AIDS-related mortality included aged ≥40 years, not being a man who have sex men, history of AIDS-defining illnesses, CD4 <200 cells/µL, ≥2 comorbidities, and non-receipt of ART. Non-AIDS mortality increased with age, injection drug use, heterosexual men, socioeconomic deprivation, CD4 200-349 cells/µL, non-receipt of ART, and comorbidities, but migrants had lower risk (adjusted hazard risk [aHR] 0.69 [95%CI 0.57-0.83]). Conclusions Mortality rates among people living with HIV (PLWH) have significantly decreased over the past two decades, with a notable shift toward non-AIDS-related causes. Continuous monitoring and effective management of these non-AIDS conditions are essential to enhance overall health outcomes.

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Section: Discussionsupporting

confidence: 81%

Evolving AIDS- and non-AIDS Mortality and Predictors in the PISCIS Cohort of People Living With HIV in Catalonia and the Balearic Islands (Spain), 1998–2020

Nomah,

Jamarkattel,

Bruguera

et al. 2024

Open Forum Infectious Diseases

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“…A cohort conducted in East Asia 13 with 33,142 persons living with HIV, during the same period, found 1.90 deaths per 100 PLHIV per year. These data indicate that Brazil presents an intermediate annual mortality rate, placed between the rates reported in the US and Asia, with discernibly better results when compared to Southeast Asia, a region with a large number of HIV cases in low-to middle-income countries with recent and unsystematic urbanization, which has resulted in difficulties in accessing antiretroviral therapy and health care [11][12][13] . This reinforces Joint United Nations Program on HIV/AIDS (UNAIDS) data, which demonstrate that socioeconomic contexts and structural measures are involved in the incidence of new infections and mortality in the population living with HIV 1 .…”

Section: Discussionmentioning

confidence: 89%

Survival and mortality profile among people living with HIV in a cohort in the Northeastern region of Brazil

Leite,

Lima,

Ximenes

et al. 2024

Rev. Inst. Med. trop. S. Paulo

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Conditions related to the acquired immune deficiency syndrome (AIDS) are still a significant cause of morbidity and mortality among people living with HIV (PLHIV). Longer survival in this population were reported to increase the risk of developing noncommunicable chronic diseases (NCDs). This study aimed to estimate the survival and causes of death according to age group and sex among PLHIV monitored at two referral centers in the Northeastern Brazil. This is a prospective, retrospective cohort with death records from 2007 to 2018, based on a database that registers causes of death using the International Classification of Disease (ICD-10), which were subsequently coded following the Coding Causes of Death in HIV (CoDe). A total of 2,359 PLHIV participated in the study, with 63.2% being men, with a follow-up period of 13.9 years. Annual mortality rate was 1.46 deaths per 100 PLHIV (95% CI: 1.33 -1.60) with a frequency of 20.9%. Risk of death for men increased by 49% when compared to women, and the risk of death in PLHIV increased by 51% among those aged 50 years and over at the time of diagnosis. It was observed that 73.5% accounted for AIDS-related deaths, 6.9% for non-AIDS defining cancer, 6.3% for external causes, and 3.2% for cardiovascular diseases. Among the youngest, 97.2% presented an AIDS-related cause of death. Highest frequency of deaths from neoplasms was among women and from external causes among men. There is a need for health services to implement strategies ensuring greater adherence to treatment, especially among men and young people. Moreover, screening for chronic diseases and cancer is essential, including the establishment of easily accessible multidisciplinary care centers that can identify and address habits such as illicit drug use and alcoholism, which are associated with violent deaths.

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Dynamics of HIV transmission among men who have sex with men in Taiwan: a mathematical modeling study

Sun,

Kawasaki,

Tunematsum

et al. 2024

Preprint

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Background In Taiwan, the human immunodeficiency virus (HIV) is primarily transmitted among men who have sex with men (MSM). Nonetheless, detailed epidemiological studies considering heterogeneity in susceptible and infectious populations remain lacking. Therefore, we modeled the HIV epidemic with heterogeneity, estimated parameters, and predicted future infection trends in order to better understand the HIV transmission dynamics among MSM. Methods We devised a computational approach to accurately estimate the number of infectious individuals during early surveillance years in Taiwan using monthly data of newly diagnosed patients with HIV from January 2005 to December 2006. Subsequently, using annual incident cases from 2005 to 2019, we estimated the susceptibility rate, transmission rates, and duration of risk and conducted short-term forecasts of HIV infection in the MSM population through mathematical modeling based on the susceptible-infected-removed model. Parameters and their values, such as the infection rates of HIV and acquired immunodeficiency syndrome (AIDS), and the removal rates of HIV and AIDS, were also estimated. Results A total of 850 infectious individuals with HIV were identified in 2005. From 2005 to 2019, approximately only 0.68% of Taiwan’s male population were estimated to be susceptible to HIV infection via MSM. The transmission rate did not significantly differ between individuals with HIV and individuals with AIDS (0.0110 and 0.107 per 10,000 individuals, respectively). The average duration of infection was 4.5 years between infection and the onset of AIDS and 2.1 years between the onset of AIDS and death. In 2019, the proportion of infectious infected individuals continuously decreased. By 2026, it is estimated that only 11.85% of individuals with HIV and 10.21% of AIDS individuals will be infectious. Conclusions Our study presents a new dynamic mathematical model for estimating infectious HIV cases among MSM in Taiwan. By accounting for heterogeneity of infectious HIV/AIDS within the MSM population, it was possible to effectively estimate the number of infections during early surveillance years and implement concentrated measures, thereby reducing infectious HIV/AIDS cases and contributing to the overall reduction in HIV/AIDS. We could better identify the target population and implement effective intervention measures at appropriate times.

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Sex stratification of the trends and risk of mortality among individuals living with HIV under different transmission categories

Cited by 3 publications

References 51 publications

Evolving AIDS- and non-AIDS Mortality and Predictors in the PISCIS Cohort of People Living With HIV in Catalonia and the Balearic Islands (Spain), 1998–2020

Evolving AIDS- and non-AIDS Mortality and Predictors in the PISCIS Cohort of People Living With HIV in Catalonia and the Balearic Islands (Spain), 1998–2020

Survival and mortality profile among people living with HIV in a cohort in the Northeastern region of Brazil

Dynamics of HIV transmission among men who have sex with men in Taiwan: a mathematical modeling study

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