Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults' cohort, France, 2006-18.

IF 3.7 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH European Journal of Public Health Pub Date : 2024-10-01 DOI:10.1093/eurpub/ckae031
Alexandre Vallée, Catherine Majerholc, David Zucman, Jean-Michel Livrozet, Caroline Laurendeau, Stéphane Bouée, François Prevoteau du Clary
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Abstract

Background: Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it with mortality in an age and gender-matched cohort of non-HIV individuals in France.

Methods: Using data from the French national health data system, we identified and included 173 712 PLWHIV (66.5% men) and 173 712 non-HIV participants (66.5% men) matched for age and gender. PLHIV were identified based on ICD-10 HIV diagnoses, HIV-specific laboratory tests, and/or prescriptions for antiretroviral therapy specific to HIV. Hazard ratios (HRs) of mortality were assessed using multiple Cox regression models.

Results: During the 13 years of follow-up (2006-18), we observed 20 018 deaths among PLWHIV compared with 6262 deaths among non-HIV participants (11.52% vs. 3.60%, P < 0.001). The over-mortality of PLWHIV was expressed by univariable HR = 2.135 (2.072-2.199), which remained significant after adjustment for region, Complementary Universal Health Insurance and AME, with multivariable HR = 2.182 (2.118-2.248). The results remained significant after adjusting for comorbidities, including infectious diseases [HR = 1.587 (1.538-1.638)]. Notably, PLWHIV were more importantly associated with mortality in women [HR = 2.966 (2.767-3.180)], compared in men [HR = 1.961 (1.898-2.027)].

Conclusion: Although the life expectancy of PLWHIV has globally increased, the causes of death should be prioritized in prevention policies and care management. Gender-specific policies should be highlighted, as we observed a higher impact of HIV mortality in women.

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全国艾滋病毒感染成人队列中的死亡率和合并症:与匹配的非艾滋病毒感染成人队列的比较,法国,2006-18 年。
背景:人类免疫缺陷病毒(HIV)仍然是全球发病和死亡的一个重要原因。本研究旨在描述全国范围内艾滋病毒感染者(PLWHIV)人群的死亡率和相关合并症,并将其与法国非艾滋病毒感染者的年龄和性别匹配人群的死亡率进行比较:利用法国国家健康数据系统的数据,我们确定并纳入了 173 712 名艾滋病毒感染者(66.5% 为男性)和 173 712 名非艾滋病毒感染者(66.5% 为男性),他们的年龄和性别均匹配。艾滋病毒感染者是根据 ICD-10 艾滋病诊断、艾滋病毒特异性实验室检测和/或艾滋病毒特异性抗逆转录病毒疗法处方确定的。采用多重考克斯回归模型评估了死亡率的危险比(HRs):在 13 年的随访期间(2006-18 年),我们观察到 20 018 例艾滋病毒感染者死亡,而非艾滋病毒感染者死亡人数为 6262 例(11.52% 对 3.60%,P 结论:虽然艾滋病毒感染者的预期寿命比非艾滋病毒感染者的预期寿命长,但艾滋病毒感染者的预期寿命比非艾滋病毒感染者的预期寿命短:虽然艾滋病毒感染者的预期寿命在全球范围内有所延长,但在预防政策和护理管理中应优先考虑死亡原因。应强调针对不同性别的政策,因为我们观察到女性感染艾滋病毒后的死亡率更高。
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来源期刊
European Journal of Public Health
European Journal of Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.60
自引率
2.30%
发文量
2039
审稿时长
3-8 weeks
期刊介绍: The European Journal of Public Health (EJPH) is a multidisciplinary journal aimed at attracting contributions from epidemiology, health services research, health economics, social sciences, management sciences, ethics and law, environmental health sciences, and other disciplines of relevance to public health. The journal provides a forum for discussion and debate of current international public health issues, with a focus on the European Region. Bi-monthly issues contain peer-reviewed original articles, editorials, commentaries, book reviews, news, letters to the editor, announcements of events, and various other features.
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