Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
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Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings. / Trickey, Adam; Van Sighem, Ard; Stover, John; Abgrall, Sophie; Grabar, Sophie; Bonnet, Fabrice; Berenguer, Juan; Wyen, Christoph; Casabona, Jordi; D'Arminio Monforte, Antonella; Cavassini, Matthias; Del Amo, Julia; Zangerle, Robert; Gill, M. John; Obel, Niels; Sterne, Jonathan A.C.; May, Margaret T.
I: AIDS, Bind 33, 2019, s. S271-S281.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
AU - Trickey, Adam
AU - Van Sighem, Ard
AU - Stover, John
AU - Abgrall, Sophie
AU - Grabar, Sophie
AU - Bonnet, Fabrice
AU - Berenguer, Juan
AU - Wyen, Christoph
AU - Casabona, Jordi
AU - D'Arminio Monforte, Antonella
AU - Cavassini, Matthias
AU - Del Amo, Julia
AU - Zangerle, Robert
AU - Gill, M. John
AU - Obel, Niels
AU - Sterne, Jonathan A.C.
AU - May, Margaret T.
PY - 2019
Y1 - 2019
N2 - Introduction:HIV cohort data from high-income European countries were compared with the UNAIDS Spectrum modelling parameters for these same countries to validate mortality rates and excess mortality estimates for people living with HIV (PLHIV) on antiretroviral therapy (ART).Methods:Data from 2000 to 2015 were analysed from the Antiretroviral Therapy Cohort Collaboration (ART-CC) for Austria, Denmark, France, Italy, the Netherlands, Spain, and Switzerland. Flexible parametric models were used to compare all-cause mortality rates in the ART-CC and Spectrum. The percentage of AIDS-related deaths and excess mortality (both are the same within Spectrum) were compared, with excess mortality defined as that in excess of the general population mortality.Results:Analyses included 94026 PLHIV with 585784 person-years of follow-up, from which there were 5515 deaths. All-cause annual mortality rates in Spectrum for 2000-2003 were 0.0121, reducing to 0.0078 in 2012-2015, whilst the ART-CC's corresponding annual mortality rates were 0.0151 [95% confidence interval (95% CI): 0.0130-0.0171] reducing to 0.0049 (95% CI: 0.0039-0.0060). The percentage of AIDS-related deaths in Spectrum was 74.7% in 2000-2003, dropping to 43.6% in 2012-2015. In the ART-CC, AIDS-related mortality constitutes 45.3% (95% CI: 38.4-52.9%) of mortality in 2000-2003 and 26.7% (95% CI: 19-46%) between 2012 and 2015. Excess mortality in the ART-CC was broadly similar to the Spectrum estimates, dropping from 75.3% (95% CI: 60.3-95.2%) in 2000-2003 to 30.7% (95% CI: 25.5-63.7%) in 2012-2015.Conclusion:All-cause mortality assumptions for PLHIV on ART in high-income European settings should be adjusted in Spectrum to be higher in 2000-2003 and decline more quickly to levels currently captured for recent years.
AB - Introduction:HIV cohort data from high-income European countries were compared with the UNAIDS Spectrum modelling parameters for these same countries to validate mortality rates and excess mortality estimates for people living with HIV (PLHIV) on antiretroviral therapy (ART).Methods:Data from 2000 to 2015 were analysed from the Antiretroviral Therapy Cohort Collaboration (ART-CC) for Austria, Denmark, France, Italy, the Netherlands, Spain, and Switzerland. Flexible parametric models were used to compare all-cause mortality rates in the ART-CC and Spectrum. The percentage of AIDS-related deaths and excess mortality (both are the same within Spectrum) were compared, with excess mortality defined as that in excess of the general population mortality.Results:Analyses included 94026 PLHIV with 585784 person-years of follow-up, from which there were 5515 deaths. All-cause annual mortality rates in Spectrum for 2000-2003 were 0.0121, reducing to 0.0078 in 2012-2015, whilst the ART-CC's corresponding annual mortality rates were 0.0151 [95% confidence interval (95% CI): 0.0130-0.0171] reducing to 0.0049 (95% CI: 0.0039-0.0060). The percentage of AIDS-related deaths in Spectrum was 74.7% in 2000-2003, dropping to 43.6% in 2012-2015. In the ART-CC, AIDS-related mortality constitutes 45.3% (95% CI: 38.4-52.9%) of mortality in 2000-2003 and 26.7% (95% CI: 19-46%) between 2012 and 2015. Excess mortality in the ART-CC was broadly similar to the Spectrum estimates, dropping from 75.3% (95% CI: 60.3-95.2%) in 2000-2003 to 30.7% (95% CI: 25.5-63.7%) in 2012-2015.Conclusion:All-cause mortality assumptions for PLHIV on ART in high-income European settings should be adjusted in Spectrum to be higher in 2000-2003 and decline more quickly to levels currently captured for recent years.
KW - AIDS
KW - cause-specific
KW - cohort
KW - death
KW - duration
KW - HIV
KW - United Nations Programme on HIV/AIDS
U2 - 10.1097/QAD.0000000000002387
DO - 10.1097/QAD.0000000000002387
M3 - Journal article
C2 - 31800404
AN - SCOPUS:85076132337
VL - 33
SP - S271-S281
JO - AIDS
JF - AIDS
SN - 1350-2840
ER -
ID: 241420101