Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: The EuroSIDA study

EuroSIDA in EuroCoord

doi:10.1371/journal.pone.0041673

Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: The EuroSIDA study

EuroSIDA in EuroCoord

University College London
University of Copenhagen
Belarusian State Medical University
University of Bonn
Stockholm County Council
Medical Academy Botkin Hospital
Medical University of Warsaw
Centrum Diagnostyki i Terapii AIDS
Hospital General de Agudos José María Ramos Mejía
Pulmologisches Zentrum
Innsbruck Medical University
Gomel State Medical University
Regional AIDS Centre
Saint-Pierre University Hospital
Institute of Tropical Medicine Antwerp
Ghent University
Klinicki Centar Univerziteta Sarajevo
Infectious Diseases Hospital
University Hospital of Infectious Diseases
Charles University
University of Southern Denmark
Aarhus University
West-Tallinn Central Hospital
Nakkusosakond Siseklinik
Helsinki University Hospital
Sorbonne Université
Université Paris Cité
Hôpital Édouard Herriot
Universite Claude Bernard Lyon 1
CHU de Nice
Institut national de la santé et de la recherche médicale
Tel Aviv Sourasky Medical Center
Hannover Medical School
University of Hamburg
IPM Study Center
Goethe University Frankfurt
Ludwig Maximilian University of Munich
University of Cologne
Athens General Hospital
1st IKA Hospital
Ippokration Genereal Hospital
Szent Lásló Hospital
St James's Hospital
Rambam Health Care Campus Israel
Hadassah University Medical Centre
Istituto Superiore di Sanita
University of Modena and Reggio Emilia
Ospedali Riuniti di Bergamo
Ospedale Generale Regionale
Ospedale S. Maria Annunziata
University of Rome La Sapienza
Ospedale V. Monaldi
IRCCS Istituto per le Malattie Infettive Lazzaro Spallanzani - Roma
San Raffaele Scientific Institute
University of Milan
Istituto Di Clinica Malattie Infettive e Tropicale
Infectology Centre of Latvia
Lithuanian AIDS Centre
Center Hospitalier de Luxembourg
Academic Medical Centre
University of Oslo
Wrocław Medical University
Medical University of Białystok
Pomeranian Medical University in Szczecin
Osrodek Diagnostyki i Terapii AIDS
Medical University of Gdańsk
Wojewodzki Szpital Specjalistyczny
Hospital Santa Maria
Santa Cruz Hospital
Hospital Curry Cabral
Victor Babes National Institute
St Petersburg AIDS Centre
Novgorod Centre for AIDS
Institute for Infectious and Tropical Diseases
Dérer Hospital
University Clinical Center Ljubljana
Hospital Universitario La Paz
Hospital Ramon y Cajal
Generalitat de Catalunya
Hospital Clinic Barcelona
Hospital de La Santa Creu I Sant Pau
Lund University
University of Zurich
University of Lausanne
University of Geneva
University of Bern
University of Basel
Kiev Centre for AIDS
Luhansk State Medical University
Odessa Region AIDS Center
Kharkiv National Medical University
Chelsea and Westminster Hospital NHS Foundation Trust
Barts Health NHS Trust
Imperial College London
Royal Sussex County Hospital
NHS Lothian

Research output: Contribution to journal › Review article › peer-review

33 Scopus citations

Abstract

Background: Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals across Europe, and Argentina. Methods: 13,310 individuals under follow-up were included in the analysis. Poisson regression investigated factors associated with the risk of death. Findings: During 82,212 person years of follow-up (PYFU) 1,147 individuals died (mortality rate 14.0 per 1,000 PYFU (95% confidence interval [CI] 13.1-14.8). Significant differences between regions were seen in the rate of all-cause, AIDS and non-AIDS related mortality (global p<0.0001 for all three endpoints). Compared to South Europe, after adjusting for baseline demographics, laboratory measurements and treatment, a higher rate of AIDS related mortality was observed in East Europe (IRR 2.90, 95%CI 1.97-4.28, p<.0001), and a higher rate of non-AIDS related mortality in North Europe (IRR 1.51, 95%CI 1.24-1.82, p<.0001). The differences observed in North Europe decreased over calendar-time, in 2009-2011, the higher rate of non-AIDS related mortality was no longer significantly different to South Europe (IRR 1.07, 95%CI 0.66-1.75, p = 0.77). However, in 2009-2011, there remained a higher rate of AIDS-related mortality (IRR 2.41, 95%CI 1.11-5.25, p = 0.02) in East Europe compared to South Europe in adjusted analysis. Interpretations: There are significant differences in the rate of all-cause mortality among HIV-positive individuals across different regions of Europe and Argentina. Individuals in Eastern Europe had an increased risk of mortality from AIDS related causes and individuals in North Europe had the highest rate of non-AIDS related mortality. These findings are important for understanding and reviewing HIV treatment strategies and policies across the European region.

Original language	English
Article number	e41673
Journal	PLoS ONE
Volume	7
Issue number	7
DOIs	https://doi.org/10.1371/journal.pone.0041673
State	Published - 23 Jul 2012
Externally published	Yes

Funding

Funders	Funder number
European Commission
Seventh Framework Programme	260694
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung	108787

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1371/journal.pone.0041673

Cite this

@article{3f17fab821c64965863f31ff86acda74,

title = "Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: The EuroSIDA study",

abstract = "Background: Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals across Europe, and Argentina. Methods: 13,310 individuals under follow-up were included in the analysis. Poisson regression investigated factors associated with the risk of death. Findings: During 82,212 person years of follow-up (PYFU) 1,147 individuals died (mortality rate 14.0 per 1,000 PYFU (95\% confidence interval [CI] 13.1-14.8). Significant differences between regions were seen in the rate of all-cause, AIDS and non-AIDS related mortality (global p<0.0001 for all three endpoints). Compared to South Europe, after adjusting for baseline demographics, laboratory measurements and treatment, a higher rate of AIDS related mortality was observed in East Europe (IRR 2.90, 95\%CI 1.97-4.28, p<.0001), and a higher rate of non-AIDS related mortality in North Europe (IRR 1.51, 95\%CI 1.24-1.82, p<.0001). The differences observed in North Europe decreased over calendar-time, in 2009-2011, the higher rate of non-AIDS related mortality was no longer significantly different to South Europe (IRR 1.07, 95\%CI 0.66-1.75, p = 0.77). However, in 2009-2011, there remained a higher rate of AIDS-related mortality (IRR 2.41, 95\%CI 1.11-5.25, p = 0.02) in East Europe compared to South Europe in adjusted analysis. Interpretations: There are significant differences in the rate of all-cause mortality among HIV-positive individuals across different regions of Europe and Argentina. Individuals in Eastern Europe had an increased risk of mortality from AIDS related causes and individuals in North Europe had the highest rate of non-AIDS related mortality. These findings are important for understanding and reviewing HIV treatment strategies and policies across the European region.",

author = "\{EuroSIDA in EuroCoord\} and Joanne Reekie and Kowalska, \{Justyna D.\} and Igor Karpov and Jurgen Rockstroh and Anders Karlsson and Aza Rakhmanova and Andrzej Horban and Ole Kirk and Lundgren, \{Jens D.\} and Amanda Mocroft and M. Losso and C. Elias and N. Vetter and R. Zangerle and A. Vassilenko and Mitsura, \{V. M.\} and O. Suetnov and N. Clumeck and \{De Wit\}, S. and M. Delforge and R. Colebunders and L. Vandekerckhove and V. Hadziosmanovic and K. Kostov and J. Begovac and L. Machala and D. Jilich and D. Sedlacek and J. Nielsen and G. Kronborg and T. Benfield and M. Larsen and J. Gerstoft and T. Katzenstein and Hansen, \{A. B.E.\} and P. Skinh{\o}j and C. Pedersen and L. Ostergaard and K. Zilmer and Jelena Smidt and M. Ristola and C. Katlama and Viard, \{J. P.\} and Girard, \{P. M.\} and Livrozet, \{J. M.\} and P. Vanhems and C. Pradier and F. Dabis and D. Neau and I. Yust",

note = "Publisher Copyright: {\textcopyright} 2012 Reekie et al.",

year = "2012",

month = jul,

day = "23",

doi = "10.1371/journal.pone.0041673",

language = "אנגלית",

volume = "7",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "7",

}

TY - JOUR

T1 - Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina

T2 - The EuroSIDA study

AU - EuroSIDA in EuroCoord

AU - Reekie, Joanne

AU - Kowalska, Justyna D.

AU - Karpov, Igor

AU - Rockstroh, Jurgen

AU - Karlsson, Anders

AU - Rakhmanova, Aza

AU - Horban, Andrzej

AU - Kirk, Ole

AU - Lundgren, Jens D.

AU - Mocroft, Amanda

AU - Losso, M.

AU - Elias, C.

AU - Vetter, N.

AU - Zangerle, R.

AU - Vassilenko, A.

AU - Mitsura, V. M.

AU - Suetnov, O.

AU - Clumeck, N.

AU - De Wit, S.

AU - Delforge, M.

AU - Colebunders, R.

AU - Vandekerckhove, L.

AU - Hadziosmanovic, V.

AU - Kostov, K.

AU - Begovac, J.

AU - Machala, L.

AU - Jilich, D.

AU - Sedlacek, D.

AU - Nielsen, J.

AU - Kronborg, G.

AU - Benfield, T.

AU - Larsen, M.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Hansen, A. B.E.

AU - Skinhøj, P.

AU - Pedersen, C.

AU - Ostergaard, L.

AU - Zilmer, K.

AU - Smidt, Jelena

AU - Ristola, M.

AU - Katlama, C.

AU - Viard, J. P.

AU - Girard, P. M.

AU - Livrozet, J. M.

AU - Vanhems, P.

AU - Pradier, C.

AU - Dabis, F.

AU - Neau, D.

AU - Yust, I.

PY - 2012/7/23

Y1 - 2012/7/23

N2 - Background: Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals across Europe, and Argentina. Methods: 13,310 individuals under follow-up were included in the analysis. Poisson regression investigated factors associated with the risk of death. Findings: During 82,212 person years of follow-up (PYFU) 1,147 individuals died (mortality rate 14.0 per 1,000 PYFU (95% confidence interval [CI] 13.1-14.8). Significant differences between regions were seen in the rate of all-cause, AIDS and non-AIDS related mortality (global p<0.0001 for all three endpoints). Compared to South Europe, after adjusting for baseline demographics, laboratory measurements and treatment, a higher rate of AIDS related mortality was observed in East Europe (IRR 2.90, 95%CI 1.97-4.28, p<.0001), and a higher rate of non-AIDS related mortality in North Europe (IRR 1.51, 95%CI 1.24-1.82, p<.0001). The differences observed in North Europe decreased over calendar-time, in 2009-2011, the higher rate of non-AIDS related mortality was no longer significantly different to South Europe (IRR 1.07, 95%CI 0.66-1.75, p = 0.77). However, in 2009-2011, there remained a higher rate of AIDS-related mortality (IRR 2.41, 95%CI 1.11-5.25, p = 0.02) in East Europe compared to South Europe in adjusted analysis. Interpretations: There are significant differences in the rate of all-cause mortality among HIV-positive individuals across different regions of Europe and Argentina. Individuals in Eastern Europe had an increased risk of mortality from AIDS related causes and individuals in North Europe had the highest rate of non-AIDS related mortality. These findings are important for understanding and reviewing HIV treatment strategies and policies across the European region.

AB - Background: Differences in access to care and treatment have been reported in Eastern Europe, a region with one of the fastest growing HIV epidemics, compared to the rest of Europe. This analysis aimed to establish whether there are regional differences in the mortality rate of HIV-positive individuals across Europe, and Argentina. Methods: 13,310 individuals under follow-up were included in the analysis. Poisson regression investigated factors associated with the risk of death. Findings: During 82,212 person years of follow-up (PYFU) 1,147 individuals died (mortality rate 14.0 per 1,000 PYFU (95% confidence interval [CI] 13.1-14.8). Significant differences between regions were seen in the rate of all-cause, AIDS and non-AIDS related mortality (global p<0.0001 for all three endpoints). Compared to South Europe, after adjusting for baseline demographics, laboratory measurements and treatment, a higher rate of AIDS related mortality was observed in East Europe (IRR 2.90, 95%CI 1.97-4.28, p<.0001), and a higher rate of non-AIDS related mortality in North Europe (IRR 1.51, 95%CI 1.24-1.82, p<.0001). The differences observed in North Europe decreased over calendar-time, in 2009-2011, the higher rate of non-AIDS related mortality was no longer significantly different to South Europe (IRR 1.07, 95%CI 0.66-1.75, p = 0.77). However, in 2009-2011, there remained a higher rate of AIDS-related mortality (IRR 2.41, 95%CI 1.11-5.25, p = 0.02) in East Europe compared to South Europe in adjusted analysis. Interpretations: There are significant differences in the rate of all-cause mortality among HIV-positive individuals across different regions of Europe and Argentina. Individuals in Eastern Europe had an increased risk of mortality from AIDS related causes and individuals in North Europe had the highest rate of non-AIDS related mortality. These findings are important for understanding and reviewing HIV treatment strategies and policies across the European region.

UR - https://www.scopus.com/pages/publications/84864194688

U2 - 10.1371/journal.pone.0041673

DO - 10.1371/journal.pone.0041673

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AN - SCOPUS:84864194688

SN - 1932-6203

VL - 7

JO - PLoS ONE

JF - PLoS ONE

IS - 7

M1 - e41673

ER -

Regional differences in AIDS and non-AIDS related mortality in HIV-positive individuals across Europe and Argentina: The EuroSIDA study

Abstract

Funding

UN SDGs

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