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首页> 外文期刊>HIV medicine >Causes of death among HIV-infected patients in the era of highly active antiretroviral therapy, Bordeaux, France, 1998-1999.
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Causes of death among HIV-infected patients in the era of highly active antiretroviral therapy, Bordeaux, France, 1998-1999.

机译：高活性抗逆转录病毒疗法时代，HIV感染患者的死亡原因，法国波尔多，1998-1999年。

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OBJECTIVES: To describe the causes of death in HIV-infected patients in the era of highly active antiretroviral therapy (HAART). METHOD: A retrospective survey conducted in Bordeaux, France. Medical records of all deaths that had occurred in 1998 and 1999 amongst patients followed within the Aquitaine cohort were reviewed by the same physician. Immediate and underlying causes of death were described, taking into account the morbidity at the time of death. RESULTS: Sixty-six deaths occurred in 1998, and 41 in 1999. Sixty-seven per cent of deceased patients were male. Median age at time of death was 43 years (range 25-71), median CD4 was 162 cells/microL (0-957); 28% of patients had a CD4 count > 200 cells/microL and 7% plasma viral load < 500 HIV-RNA copies/mL. Amongst morbidity present at the time of death, there were 23 bacterial infections, 16 non-Hodgkin's lymphomas, 16 cirrhoses, 15 non HIV-related malignancies, 13 central nervous system diseases and 10 myocardiopathies. The main immediate causes of death were: multiple organ failure (21%), coma (18%), septic shock (15%) and acute respiratory failure (14%). Underlying causes of death were AIDS-defining events (48%), non AIDS HIV-related infection (3%), hepatitis B- or C-associated cirrhosis (14%), non HIV-related malignancies (11%), cardiovascular events (10%), suicide and overdose (6%), treatment-related fatalities (4%), injury (2%) and unknown (2%). Patients dying from AIDS-related events were more often female, had a lower CD4 count, a higher level of HIV-RNA, a shorter history of HIV infection and were less often coinfected with hepatitis B and C viruses than those dying from other underlying causes. CONCLUSIONS: AIDS-related events are no longer the major causes of death of HIV-infected patients in the era of HAART. This evolving mortality pattern justifies an adaptation of both the epidemiological surveillance and the clinical monitoring of HIV-infected patients.
机译：目的：描述在高效抗逆转录病毒疗法（HAART）时代HIV感染患者的死亡原因。方法：在法国波尔多进行的回顾性调查。同一位医生对1998年和1999年在阿基坦大学队列中随访的所有患者的所有病历进行了医学检查。描述了直接和潜在的死亡原因，同时考虑了死亡时的发病率。结果：1998年有66例死亡，1999年有41例死亡。死者中有67％是男性。死亡时的中位年龄为43岁（范围为25-71），中位数CD4为162个细胞/微升（0-957）; 28％的患者CD4计数> 200细胞/微升，而7％的血浆病毒载量<500 HIV-RNA拷贝/毫升。在死亡时存在的发病率中，有23例细菌感染，16例非霍奇金淋巴瘤，16例肝硬化，15例非HIV相关的恶性肿瘤，13例中枢神经系统疾病和10例心肌病。死亡的主要直接原因是：多器官功能衰竭（21％），昏迷（18％），败血性休克（15％）和急性呼吸衰竭（14％）。潜在的死亡原因是：定义艾滋病的事件（48％），与艾滋病无关的艾滋病相关感染（3％），与乙肝或丙肝相关的肝硬化（14％），与艾滋病无关的恶性肿瘤（11％），心血管事件（10％），自杀和过量（6％），与治疗有关的死亡（4％），伤害（2％）和未知（2％）。死于艾滋病相关事件的患者与死于其他潜在原因的患者相比，死于女性的患者更多是女性，CD4计数较低，HIV-RNA水平较高，HIV感染史较短且并发乙型和丙型肝炎病毒的频率较低。结论：在HAART时代，与艾滋病有关的事件不再是导致HIV感染患者死亡的主要原因。这种不断发展的死亡率模式证明了对艾滋病毒感染患者进行流行病学监测和临床监测的合理性。

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