Causes of death in people living with HIV from a North London cohort between 2006 and 2023: A descriptive analysis.

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2025-06-04 DOI:10.1111/hiv.70054

Linda Cheyenne Vaccari, Damien K Ming, Jane Hazell, Alan Hunter, Fiona M Burns, Robert F Miller

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引用次数: 0

Abstract

Background: The provision of highly active anti-retroviral therapy has improved outcomes for people with HIV, worldwide. There are few data on trends and changes in the cause of death among people with HIV in the United Kingdom since its advent.

Methods: We retrospectively reviewed deaths in people attending HIV services at Royal Free Hospital London between 2006 and 2023. Cause of death was categorized using the CoDe protocol. Analysis included description of demographics over time, HIV-specific metrics (late diagnoses, AIDS-defining illnesses) and aspects related to HIV treatment and trends in non-AIDS-related causes of death.

Results: Of 529 deaths, 79.8% were male. Cause of death was non-AIDS-defining malignancy 21.4%, non-AIDS-defining infection 12.1%, AIDS-defining infection 11.2%, AIDS-defining malignancy 7.8%, self-harm 9.3%, cardiovascular 8.3%, liver 2.8%, respiratory 2.6%, other 7.2% and unknown 17.4%. Comparing 2006-2011 and 2018-2023, the proportion of those dying from AIDS-defining infection and malignancy fell from 13.8% to 7.1%, and from 13.8% to 3.1%, respectively; median age at death increased from 44.9 years (interquartile range [IQR] 39.7-52.4) to 58.0 (IQR 52.0-67.7): p < 0.001 and median interval between HIV diagnosis and death increased from 8.5 years (IQR 2.9-14.0) to 19.1 (IQR 11.8-26.1): p < 0.001.

Conclusions: Between 2006 and 2023, there was a significant increase in median age at death and in the interval between HIV diagnosis and death. The proportion of deaths associated with AIDS-defining infection and malignancy fell, while non-AIDS-defining infection, malignancy and deaths from self-harm increased. These data suggest that focusing on earlier diagnosis, holistic clinical management and support for mitigating modifiable lifestyle risk factors including cancer screening and mental health services could result in improved outcomes and reduce preventable deaths.

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2006年至2023年伦敦北部HIV感染者死亡原因的描述性分析

背景：在世界范围内，提供高效抗逆转录病毒治疗改善了艾滋病毒感染者的预后。自艾滋病毒出现以来，关于英国艾滋病毒感染者死亡原因的趋势和变化的数据很少。方法：我们回顾性分析了2006年至2023年在伦敦皇家自由医院接受艾滋病服务的死亡人数。死因是按照CoDe规程分类的。分析包括描述一段时间以来的人口统计数据、艾滋病毒特定指标（晚期诊断、艾滋病定义疾病）以及与艾滋病毒治疗有关的方面和非艾滋病相关死亡原因的趋势。结果：529例死亡中，男性占79.8%。死亡原因为非艾滋病定义性恶性肿瘤21.4%、非艾滋病定义性感染12.1%、艾滋病定义性感染11.2%、艾滋病定义性恶性肿瘤7.8%、自残9.3%、心血管8.3%、肝脏2.8%、呼吸2.6%、其他7.2%和未知17.4%。与2006-2011年和2018-2023年相比，死于艾滋病定义感染和恶性肿瘤的人数比例分别从13.8%降至7.1%和13.8%降至3.1%；死亡年龄中位数从44.9岁（四分位数范围[IQR] 39.7-52.4）增加到58.0岁（IQR 52.0-67.7）： p结论：2006 - 2023年间，死亡年龄中位数以及HIV诊断与死亡之间的时间间隔均显著增加。与艾滋病定义感染和恶性肿瘤相关的死亡比例下降，而与非艾滋病定义感染、恶性肿瘤和自残死亡相关的死亡比例上升。这些数据表明，注重早期诊断、全面临床管理和支持减轻可改变的生活方式风险因素，包括癌症筛查和心理健康服务，可能会改善结果，减少可预防的死亡。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.