Mortality and Morbidity of HIV Infected Patients Receiving HAART: A Cohort Study

George      Panos; George      Samonis; Vangelis   G.   Alexiou; Garyfallia   A.   Kavarnou; Gerasimos      Charatsis; Matthew   E.   Falagas

doi:10.2174/157016208784324976

Abstract

HAART has substantially decreased mortality and morbidity among HIV-infected patients. We retrospectively analyzed morbidity and mortality in a cohort of HIV-infected adult patients with prolonged and frequent follow up (1987- 2006). The study was divided in pre-HAART and HAART period for comparative reasons. In total, 615 HIV-infected patients (54 females) were included in our study. 144 died during the pre-HAART period (51.4 deaths per 100 patients). During the HAART period only 38 patients died from a total of 335 patients receiving HAART (11.3 deaths per 100 patients); the follow up in this part of the cohort was 2139 persons-years and the death incidence 1.77 deaths/per 100 personyears. The subanalysis excluding patients who died within 3 months from admission showed that death incidence among patients that have been receiving HAART from the time of diagnosis (1.2 deaths per 100 person-years) was slightly lower, compared to the death incidence of patients treated for some time with non-HAART as well (1.58 deaths per 100 personsyears). After the availability of HAART in this unit, the proportion of non-AIDS related deaths increased significantly from 8% to 40% (p < 0.001); infections remained the leading cause of death in both groups of patients. The most common non-AIDS related causes of deaths were cancer and coronary disease. Our data from the studied cohort adds to the relevant literature regarding the dramatic reduction of morbidity and mortality that occurred after the availability of HAART.

Keywords: death incidence, follow-up, causes of death, opportunistic infections, adherence

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