Increased mortality and morbidity risk in people with early HIV care interruption in Spain.

IF 3.1 2区医学 Q3 IMMUNOLOGY AIDS Pub Date : 2025-07-15 Epub Date: 2025-03-07 DOI:10.1097/QAD.0000000000004175

Rebeca Izquierdo, Marta Rava, Félix Gutiérrez, Lucio J García-Fraile, Melchor Riera, Arkaitz Imaz, Cesar Sotomayor, Sergio Reus, Rafael Rubio, José A Iribarren, Inma Jarrín

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Abstract

Objective: We assessed the association between early HIV medical care interruption (MCI) and the development of AIDS-defining events (ADEs), serious non-AIDS events (SNAEs), and death among people with HIV (PWH) from the CoRIS cohort.

Design: We included antiretroviral-naive individuals aged at least 18 years at enrollment, recruited between 1 January 2004 and 30 May 2021, and followed-up until 30 November 2023.

Methods: Early MCI was defined as a time interval over 15 months between two consecutive visits, where the first of these visits occurred within the first 15 months of enrollment. We used Poisson regression models to assess the association between early MCI and the outcomes.

Results: Of 14 594 individuals, 1067 (7.3%) experienced an early MCI. Individuals with early MCI showed higher risk of developing ADEs (adjusted incidence rate ratio, aIRR: 2.92; 95% confidence interval (CI) 2.24-3.81) than those who did not. Early MCI was associated with a higher risk of overall mortality (2.15; 95% CI 1.75-2.64), AIDS-related deaths (3.54; 95% CI 2.35-5.44) and deaths due to liver diseases (2.44; 95% CI 1.19-4.98), but was not with mortality due to non-AIDS-defining malignancies (1.20; 95% CI 0.58-2.49). The primary underlying causes of death among individuals with early MCI were AIDS-related deaths (17%), non-AIDS-defining malignancies (11.7%) and liver diseases (10.6%).

Conclusion: Early MCI was associated with an increased rate of ADEs and death, underscoring the need to design and implement public health strategies that bolster retention in care among PWH.

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2004-2023年西班牙艾滋病毒早期治疗中断者死亡率和发病率风险增加。

目的：我们评估CoRIS队列中早期HIV医疗中断（MCI）与艾滋病定义事件（ADEs）、严重非艾滋病事件（snae）和HIV感染者（PWH）死亡之间的关系。设计：我们纳入了在2004年1月1日至2021年5月30日期间招募的年龄至少为18岁的未接受抗逆转录病毒治疗的个体，并随访至2023年11月30日。方法：早期MCI被定义为两次连续访问之间的时间间隔超过15个月，其中第一次访问发生在入组的前15个月内。我们使用泊松回归模型来评估早期轻度认知损伤与预后之间的关系。结果：14594例患者中，1067例（7.3%）经历了早期轻度认知障碍。早期轻度认知损伤个体发生ade的风险较高(调整发生率比，aIRR: 2.92；95%可信区间（CI） 2.24-3.81)。早期轻度认知损伤与较高的总死亡率相关(2.15；95% CI 1.75-2.64)，艾滋病相关死亡(3.54；95% CI 2.35-5.44)和肝脏疾病导致的死亡(2.44；95% CI 1.19-4.98)，但与非艾滋病定义恶性肿瘤的死亡率无关(1.20；95% ci 0.58-2.49)。早期轻度认知损伤患者的主要潜在死亡原因是艾滋病相关死亡（17%）、非艾滋病定义的恶性肿瘤（11.7%）和肝脏疾病（10.6%）。结论：早期轻度认知损伤与不良事件发生率和死亡率的增加有关，这强调了设计和实施公共卫生策略的必要性，以加强PWH患者的护理保留。

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

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.