Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem

Detalhes bibliográficos
Autor(a) principal: Leite, Pedro H. A. C.
Data de Publicação: 2022
Outros Autores: Coelho, Lara E., Cardoso, Sandra Wagner, Moreira, Ronaldo I., Veloso, Valdiléa G., Grinsztejn, Beatriz, Luz, Paula M.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/53915
Resumo: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
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spelling Leite, Pedro H. A. C.Coelho, Lara E.Cardoso, Sandra WagnerMoreira, Ronaldo I.Veloso, Valdiléa G.Grinsztejn, BeatrizLuz, Paula M.2022-07-22T10:25:47Z2022-07-22T10:25:47Z2022LEITE, Pedro H. A. C. et al. Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem. BMC Infectious Diseases, v. 22, n. 1, p. 1-12, 2022.1471-2334https://www.arca.fiocruz.br/handle/icict/5391510.1186/s12879-022-07451-xengBMCEarly mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting probleminfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Background: Global mortality from AIDS-related diseases has been declining since 2005, resulting primarily from the widespread use and early initiation of combination antiretroviral therapy. Despite the significant improvements, high rates of early mortality, usually defined as that occurring within the 1st year of entry to care, have been observed, especially in resource-limited settings. This analysis draws upon data from an observational cohort of people with HIV (PWH) followed at a reference center for HIV/AIDS care and research in the city of Rio de Janeiro, Brazil, to identify the pattern and factors associated with early mortality. Methods: The study population includes PWH aged 18 or older followed at the National Institute of Infectious Diseases Evandro Chagas who were enrolled between 2004 and 2015. The primary outcome was early mortality, defined as deaths occurring within 1 year of inclusion in the cohort, considering two follow-up periods: 0 to 90 days (very early mortality) and 91 to 365 days (early mortality). Cox proportional hazards models were used to identify the variables associated with the hazard of very early and early mortality. Results: Overall, 3879 participants contributed with 3616.4 person-years of follow-up. Of 220 deaths, 132 happened in the first 90 days and 88 between 91 and 365 days. Very early mortality rate ratios (MRR) show no statistically significant temporal differences between the periods 2004-2006 to 2013-2015. In contrast, for early mortality, a statistically significant decreasing trend was observed: mortality rates in the periods 2004-2006 (MR = 5.5; 95% CI 3.9-7.8) and 2007-2009 (MR = 3.9; 95% CI 2.7-5.7) were approximately four and three-fold higher when compared to 2013-2015 (MR = 1.4; 95% CI 0.7-2.7). Low CD4 count and prior AIDS-defining illness were strongly associated with higher hazard ratios of death, especially when considering very early mortality. Conclusions: The present study shows an excess of mortality in the 1st year of follow-up with no changes in the mortality rates within 90 days among PWH from Rio de Janeiro. We note the significant impact of initiating treatment with immunosuppression, as evidenced by the increased risk of death among those with low CD4 cell count and with AIDS-defining illnesses.Acquired immunodeficiency syndromeCohort studiesHIVMortalityRisk factorsSurvival analysisinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALEarly_Paula_Luz_etal_INI_2022.pdfEarly_Paula_Luz_etal_INI_2022.pdfapplication/pdf1339950https://www.arca.fiocruz.br/bitstream/icict/53915/2/Early_Paula_Luz_etal_INI_2022.pdfa9210f6b1d77987f7e83279a65143dd2MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/53915/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51icict/539152023-04-29 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dc.title.pt_BR.fl_str_mv Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
title Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
spellingShingle Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
Leite, Pedro H. A. C.
Acquired immunodeficiency syndrome
Cohort studies
HIV
Mortality
Risk factors
Survival analysis
title_short Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
title_full Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
title_fullStr Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
title_full_unstemmed Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
title_sort Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem
author Leite, Pedro H. A. C.
author_facet Leite, Pedro H. A. C.
Coelho, Lara E.
Cardoso, Sandra Wagner
Moreira, Ronaldo I.
Veloso, Valdiléa G.
Grinsztejn, Beatriz
Luz, Paula M.
author_role author
author2 Coelho, Lara E.
Cardoso, Sandra Wagner
Moreira, Ronaldo I.
Veloso, Valdiléa G.
Grinsztejn, Beatriz
Luz, Paula M.
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Leite, Pedro H. A. C.
Coelho, Lara E.
Cardoso, Sandra Wagner
Moreira, Ronaldo I.
Veloso, Valdiléa G.
Grinsztejn, Beatriz
Luz, Paula M.
dc.subject.en.pt_BR.fl_str_mv Acquired immunodeficiency syndrome
Cohort studies
HIV
Mortality
Risk factors
Survival analysis
topic Acquired immunodeficiency syndrome
Cohort studies
HIV
Mortality
Risk factors
Survival analysis
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
publishDate 2022
dc.date.accessioned.fl_str_mv 2022-07-22T10:25:47Z
dc.date.available.fl_str_mv 2022-07-22T10:25:47Z
dc.date.issued.fl_str_mv 2022
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv LEITE, Pedro H. A. C. et al. Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem. BMC Infectious Diseases, v. 22, n. 1, p. 1-12, 2022.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/53915
dc.identifier.issn.pt_BR.fl_str_mv 1471-2334
dc.identifier.doi.none.fl_str_mv 10.1186/s12879-022-07451-x
identifier_str_mv LEITE, Pedro H. A. C. et al. Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem. BMC Infectious Diseases, v. 22, n. 1, p. 1-12, 2022.
1471-2334
10.1186/s12879-022-07451-x
url https://www.arca.fiocruz.br/handle/icict/53915
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/53915/2/Early_Paula_Luz_etal_INI_2022.pdf
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