Regional Differences in AIDS and Non-AIDS Related Mortality in HIV-Positive Individuals across Europe and Argentina The EuroSIDA Study 英文参考文献.docVIP

Regional Differences in AIDS and Non-AIDS Related Mortality in HIV-Positive Individuals across Europe and Argentina The EuroSIDA Study 英文参考文献.doc

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Regional Differences in AIDS and Non-AIDS Related Mortality in HIV-Positive Individuals across Europe and Argentina The EuroSIDA Study 英文参考文献

RegionalDifferencesinAIDSandNon-AIDSRelated MortalityinHIV-PositiveIndividualsacrossEuropeand Argentina:TheEuroSIDAStudy JoanneReekie1*,JustynaD.Kowalska2,IgorKarpov3,JurgenRockstroh4,AndersKarlsson5, AzaRakhmanova6,AndrzejHorban7,OleKirk2,8,JensD.Lundgren2,8,AmandaMocroft1,forEuroSIDA inEuroCoord 1MedicalSchool,UniversityCollegeLondon,London,UnitedKingdom,2CopenhagenHIVProgramme,UniversityofCopenhagen,Copenhagen,Denmark,3BelarusState Medical University, Minsk, Belarus, 4University of Bonn, Bonn, Germany, 5Venhaelsan-Sodersjukhuset, Stockholm, Sweden, 6Medical Academy Botkin Hospital, St Petersburg, Russia, 7Warsaw Medical University, Hospital of Infectious Diseases, Warsaw, Poland, 8Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark Abstract Background:DifferencesinaccesstocareandtreatmenthavebeenreportedinEasternEurope,aregionwithoneofthe fastestgrowingHIVepidemics,comparedtotherestofEurope.Thisanalysisaimedtoestablishwhetherthereareregional differencesinthemortalityrateofHIV-positiveindividualsacrossEurope,andArgentina. Methods: 13,310 individuals under follow-up were included in the analysis. Poisson regression investigated factors associatedwiththeriskofdeath. Findings:During82,212personyearsoffollow-up(PYFU)1,147individualsdied(mortalityrate14.0per1,000PYFU(95% confidenceinterval[CI]13.1–14.8).Significantdifferencesbetweenregionswereseenintherateofall-cause,AIDSandnon- AIDSrelatedmortality(globalp,0.0001forallthreeendpoints).ComparedtoSouthEurope,afteradjustingforbaseline demographics,laboratorymeasurementsandtreatment,ahigherrateofAIDSrelatedmortalitywasobservedinEastEurope (IRR2.90,95%CI1.97–4.28,p,.0001),andahigherrateofnon-AIDSrelatedmortalityinNorthEurope(IRR1.51,95%CI1.24– 1.82,p,.0001).ThedifferencesobservedinNorthEuropedecreasedovercalendar-time,in2009–2011,thehigherrateof non-AIDS related mortality was no longer significantly different to South Europe (IRR 1.07, 95%CI 0.66–1.75, p=0.77). However,in2009–2011,thereremainedahigherra

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