AIDS-defining events increase mortality risk, says study

February 9, 2018 by Paul Govern, Vanderbilt University

When they occur among people living with HIV, certain cancers and opportunistic infections are considered by health authorities as AIDS-defining events, or ADEs.

The Centers for Disease Control and Prevention recognizes 27 ADEs, from pneumonia to tuberculosis to cervical cancer to wasting syndrome. When a is attributed to AIDS, usually one or more recognized ADEs is involved.

The availability of effective antiretroviral drug therapy has rendered HIV/AIDS a chronic disease in much of the world, no longer acutely fatal when treated. Among people living with HIV, at least in some developed regions, a so-called non-AIDS death appears at least as likely as a death attributed directly to AIDS.

In a study published recently in the Journal of the International AIDS Society, April Pettit, MD, MPH, assistant professor of Medicine, and colleagues focus on non-AIDS mortality among people on antiretroviral treatment in relatively high-income countries. They specifically examine mortality among patients who've survived an ADE since starting their HIV/AIDS .

The team examined records of 124,587 antiretroviral patients, with a median follow-up period of 5.2 years. Data were provided by the international Antiretrovial Therapy Cohort Collaboration (ART-CC).

The overall death rate was 9 percent. Among all deaths, 36 percent were coded as non-AIDS deaths, 24 percent were coded as AIDS deaths, and death codes were missing for the rest.

After adjusting their analysis for medical and demographic covariates (including time-updated covariates), the authors found that having survived an ADE is associated with 121 percent greater risk of non-AIDS death.

"These findings suggest that a common pathway may be independently driving both ADEs and NADE (non-AIDS) mortality. These findings underscore the need for future studies to elucidate a potential mechanism for this association, including that of chronic inflammation and immune activation due to ADEs," the authors wrote.

They focused on three events representing extremes of ADE severity: having survived tuberculosis, considered a mild ADE, is associated with 68 percent greater risk of non-AIDS death; having survived Pneumocystis jirovecii pneumonia (PJP), also considered mild, is associated with 121 percent greater risk of non-AIDS death; having survived non-Hodgkin lymphoma, considered severe, is associated with 195 percent greater risk of non-AIDS death.

Of these three ADEs, only TB was associated with a higher cardiovascular death rate. PJP was associated with higher rates of respiratory death and accident/suicide/overdose, with the latter association suggesting the influence of unmeasured confounders, according to the authors, such as mental illness and alcohol or drug abuse. Smoking and , neither of which are measured by the ART-CC, are two other known confounders not included in the analysis.

The most frequent causes of non-AIDS death overall included cancer at 17 percent, accident/suicide/overdose at 16 percent, cardio-vascular disease also at 16 percent, non-AIDS infections at 15 percent, and liver disease at 13 percent.

Explore further: HIV/AIDS deaths are down in South Africa, but most are still unacknowledged

Related Stories

HIV/AIDS deaths are down in South Africa, but most are still unacknowledged

October 29, 2015
After peaking in 2007, AIDS mortality in South Africa has decreased with the widespread introduction of effective antiretroviral therapy, according to updated estimates published in AIDS, official journal of the International ...

Men at higher risk of dying of AIDS than women: UNAIDS

December 1, 2017
Men are less likely to test for HIV or access antiretroviral therapy and, therefore, are more likely to die of AIDS-related illnesses than women, UNAIDS said on Friday.

Increased sudden cardiac death rate among HIV patients

May 16, 2012
(HealthDay) -- Patients with HIV/AIDS have a significantly increased risk of sudden cardiac death (SCD), according to a study published in the May 22 issue of the Journal of the American College of Cardiology.

Facts about HIV/AIDS worldwide in 2011

July 18, 2012
Here are some key facts and figures on HIV/AIDS in 2011, released by UNAIDS on Wednesday ahead of the International AIDS Conference set to take place in Washington on July 22-27.

Causes of death shifting in people with HIV

July 18, 2014
HIV-positive adults in high income countries face a substantially reduced risk of death from AIDS-related causes, cardiovascular disease, and liver disease compared with a decade ago, according to a large international study ...

Recommended for you

HIV exports viral protein in cellular packages

February 15, 2018
HIV may be able to affect cells it can't directly infect by packaging a key protein within the host's cellular mail and sending it out into the body, according to a new study out of a University of North Carolina Lineberger ...

Can gene therapy be harnessed to fight the AIDS virus?

February 13, 2018
For more than a decade, the strongest AIDS drugs could not fully control Matt Chappell's HIV infection. Now his body controls it by itself, and researchers are trying to perfect the gene editing that made this possible.

Big data methods applied to the fitness landscape of the HIV envelope protein

February 7, 2018
Despite significant advances in medicine, there is still no effective vaccine for the human immunodeficiency virus (HIV), although recent hope has emerged through the discovery of antibodies capable of neutralizing diverse ...

Scientists report big improvements in HIV vaccine production

February 5, 2018
Research on HIV over the past decade has led to many promising ideas for vaccines to prevent infection by the AIDS virus, but very few candidate vaccines have been tested in clinical trials. One reason for this is the technical ...

Microbiome research refines HIV risk for women

January 25, 2018
Drawing from data collected for years by AIDS researchers in six African nations, scientists have pinpointed seven bacterial species whose presence in high concentrations may significantly increase the risk of HIV infection ...

Researchers find latent HIV reservoirs inherently resistant to elimination by CD8+ T-cells

January 22, 2018
The latest "kick-and-kill" research to eliminate the HIV virus uncovered a potential obstacle in finding a cure. A recent study by researchers at the George Washington University (GW) found that latent HIV reservoirs show ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

ElijahB1Danchi
not rated yet Feb 09, 2018
HIV cure is found, i never believe that this will work i have spend a lot when getting drugs from the hospital to keep me healthy, what i was waiting for is death because i was broke, one day i hard about this great man who is well know of HIV and cancer cure, i decided to email him, unknowingly to me that this will be the end of the HIV aids in my body, he prepare the herb for me, and give me instruction on how to take it, at the end of the two week, he told me to go to the hospital for a check up, and i went, surprisingly after the test the doctor confirm me negative, i thought it was a joke, i went to other hospital was also negative, then i took my friend who was also HIV positive to the Dr, after the treatment she was also confirm negative . He also have the herb to cure cancer please i want every one with this virus to be free, that is why am dropping his email address, dr.atakumaoracle@outlook.com and his contact +2347064693371 dr.atakumaoracle@outlook.com do email him he

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.