Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study

R Weber; CA Sabin; Nina Friis-Møller; P Reiss; WM El-Sadr; O Kirk; F Dabis; MG Law; C Pradier; S de Wit; B Åkerlund; G Calvo; A D´arminio Monforte; M Rickenbach; B Ledergerber; AN Phillips; Jens Dilling Lundgren

Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study

R Weber, CA Sabin, Nina Friis-Møller, P Reiss, WM El-Sadr, O Kirk, F Dabis, MG Law, C Pradier, S de Wit, B Åkerlund, G Calvo, A D´arminio Monforte, M Rickenbach, B Ledergerber, AN Phillips, Jens Dilling Lundgren

875 Citationer (Scopus)

Abstract

BACKGROUND: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. METHODS: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow-up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. RESULTS: There were 1246 deaths (5.3%; 1.6 per 100 person-years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis co-infections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for <50 vs > or =500/microL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P = .008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P = .02). CONCLUSIONS: Liver-related death was the most frequent cause of non-AIDS-related death. We found a strong association between immunodeficiency and risk of liver-related death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.

Originalsprog	Engelsk
Tidsskrift	Archives of Internal Medicine
Vol/bind	166
Udgave nummer	15
Sider (fra-til)	1632-1641
ISSN	0003-9926
Status	Udgivet - 2006

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http://archinte.ama-assn.org/cgi/content/short/166/15/1632

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Weber, R., Sabin, CA., Friis-Møller, N., Reiss, P., El-Sadr, WM., Kirk, O., Dabis, F., Law, MG., Pradier, C., de Wit, S., Åkerlund, B., Calvo, G., D´arminio Monforte, A., Rickenbach, M., Ledergerber, B., Phillips, AN., & Lundgren, J. D. (2006). Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study. Archives of Internal Medicine, 166(15), 1632-1641. http://archinte.ama-assn.org/cgi/content/short/166/15/1632

Weber, R, Sabin, CA, Friis-Møller, N, Reiss, P, El-Sadr, WM, Kirk, O, Dabis, F, Law, MG, Pradier, C, de Wit, S, Åkerlund, B, Calvo, G, D´arminio Monforte, A, Rickenbach, M, Ledergerber, B, Phillips, AN & Lundgren, JD 2006, 'Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study', Archives of Internal Medicine, bind 166, nr. 15, s. 1632-1641. <http://archinte.ama-assn.org/cgi/content/short/166/15/1632>

@article{d185859333dc40c79ac77d6c471f5d47,

title = "Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study",

abstract = "BACKGROUND: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. METHODS: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow-up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. RESULTS: There were 1246 deaths (5.3%; 1.6 per 100 person-years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis co-infections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for <50 vs > or =500/microL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P = .008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P = .02). CONCLUSIONS: Liver-related death was the most frequent cause of non-AIDS-related death. We found a strong association between immunodeficiency and risk of liver-related death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.",

author = "R Weber and CA Sabin and Nina Friis-M{\o}ller and P Reiss and WM El-Sadr and O Kirk and F Dabis and MG Law and C Pradier and {de Wit}, S and B {\AA}kerlund and G Calvo and {D´arminio Monforte}, A and M Rickenbach and B Ledergerber and AN Phillips and Lundgren, {Jens Dilling}",

year = "2006",

language = "English",

volume = "166",

pages = "1632--1641",

journal = "JAMA Internal Medicine",

issn = "2168-6106",

publisher = "The JAMA Network",

number = "15",

}

TY - JOUR

T1 - Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study

AU - Weber, R

AU - Sabin, CA

AU - Friis-Møller, Nina

AU - Reiss, P

AU - El-Sadr, WM

AU - Kirk, O

AU - Dabis, F

AU - Law, MG

AU - Pradier, C

AU - de Wit, S

AU - Åkerlund, B

AU - Calvo, G

AU - D´arminio Monforte, A

AU - Rickenbach, M

AU - Ledergerber, B

AU - Phillips, AN

AU - Lundgren, Jens Dilling

PY - 2006

Y1 - 2006

N2 - BACKGROUND: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. METHODS: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow-up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. RESULTS: There were 1246 deaths (5.3%; 1.6 per 100 person-years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis co-infections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for <50 vs > or =500/microL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P = .008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P = .02). CONCLUSIONS: Liver-related death was the most frequent cause of non-AIDS-related death. We found a strong association between immunodeficiency and risk of liver-related death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.

AB - BACKGROUND: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. METHODS: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow-up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. RESULTS: There were 1246 deaths (5.3%; 1.6 per 100 person-years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis co-infections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for <50 vs > or =500/microL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P = .008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P = .02). CONCLUSIONS: Liver-related death was the most frequent cause of non-AIDS-related death. We found a strong association between immunodeficiency and risk of liver-related death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop.

M3 - Journal article

SN - 2168-6106

VL - 166

SP - 1632

EP - 1641

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

IS - 15

ER -

Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study

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