TY - JOUR TI - Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS AU - Lewden, Charlotte AU - Salmon, Dominique AU - Morlat, Philippe AU - Bévilacqua, Sibylle AU - Jougla, Eric AU - Bonnet, Fabrice AU - Héripret, Laurence AU - Costagliola, Dominique AU - May, Thierry AU - Chêne, Geneviève AU - Mortality 2000 study group T2 - International journal of epidemiology AB - BACKGROUND: In the era of highly active antiretroviral therapy (HAART) mortality has decreased substantially among human immunodeficiency virus (HIV)-infected people with access to HAART, but there are concerns regarding co-morbidities and adverse effects of HAART, which may impair vital prognosis. The Mortality 2000 study examined the causes of death in HIV-infected adults at a national level in France in the year 2000. METHODS: All French hospital wards known to be involved in the management of HIV infection were asked to notify prospectively the deaths that occurred in 2000 among HIV-infected adults. The causes of death were documented using a standardized questionnaire. RESULTS: The 185 participating wards notified 964 deaths. The main underlying causes of death were AIDS-related (47%, non-Hodgkin's lymphoma: 23%), viral hepatitis (11%, hepatitis C: 9%, hepatitis B: 2%), cancer not related to AIDS or hepatitis (11%), cardiovascular disease (7%), bacterial infections (6%), suicide (4%), and adverse effect of antiretroviral treatments (1%). Among AIDS-related deaths, HIV infection had been diagnosed recently in 20%. Smoking was recorded in 72% of cancer-related deaths and alcohol consumption in 54% of hepatitis-related deaths. Among non-HIV related deaths between 25 and 64 years, the proportion of infectious diseases (including HCV and HBV-related deaths) was higher in HIV-infected adults than in the general population. CONCLUSIONS: Improved strategies for detecting HIV infection before AIDS-defining complications occur are needed in the era of HAART. The prevention of non-AIDS related cancers, especially lung cancer, the management of non-Hodgkin's lymphoma, and of viral hepatitis are also important priorities. DA - 2005/02// PY - 2005 DO - 10.1093/ije/dyh307 DP - NCBI PubMed VL - 34 IS - 1 SP - 121 EP - 130 J2 - Int J Epidemiol LA - eng SN - 0300-5771 ST - Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy KW - Acquired Immunodeficiency Syndrome KW - Adult KW - Age Factors KW - Aged KW - Antiretroviral Therapy, Highly Active KW - CD4 Lymphocyte Count KW - Comorbidity KW - Female KW - France KW - HIV Infections KW - Health Surveys KW - Hepatitis, Viral, Human KW - Humans KW - Male KW - Middle Aged KW - Neoplasms ER -