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Elevated risks of death for diabetes mellitus and cardiovascular diseases in Italian AIDS cases.doc

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Elevated risks of death for diabetes mellitus and cardiovascular diseases in Italian AIDS cases

Serraino et al. AIDS Research and Therapy 2010, 7:11 /content/7/1/11 SHORT REPORT Open Access Elevated risks of death for diabetes mellitus and Short report cardiovascular diseases in Italian AIDS cases Diego Serraino*1, Silvia Bruzzone2, Antonella Zucchetto1, Barbara Suligoi3, Angela De Paoli1, Simona Pennazza2, Laura Camoni3, Luigino Dal Maso1, Paoli De Paoli4 and Giovanni Rezza3 Abstract After the introduction of highly active antiretroviral therapies (HAART), an increased incidence of insulin resistance, diabetes mellitus (DM), and cardiovascular diseases has been described. The impact of such conditions on mortality in the post-HAART era has been also assessed in various modes in the literature. In this paper, we report on the death risks for DM, myocardial infarction, and chronic ischemic heart diseases that were investigated among 9662 Italian AIDS cases diagnosed between 1999 and 2005. Death certificates reporting DM, myocardial infarction, and chronic ischemic heart diseases were reviewed to identify the underlying cause of death, and to compare the observed numbers of deaths with the expected ones from the sex- and age-matched, general population of Italy. Person-years at risk of death were computed from date of AIDS diagnosis up to date of death or to December 31, 2006. Standardized mortality ratios (SMR) and their 95% confidence intervals (CI) were computed. DM and cardiovascular diseases were the cause of death for 43 out of 3101 deceased AIDS cases (i.e., 1.4% of all deaths). In comparison with the general population, the risks of death were 6.4-fold higher for DM (95% CI:3.5-10.8), 2.3-fold higher for myocardial infarction (95% CI:1.4-3.7) and 3.0 for chronic ischemic heart diseases (95% CI: 1.5-5.2). Findings nosed according to the 1993 revised European AIDS definition [12], and they are compulsorily reported to the HIV-infected people are at increasing risk of developing several non-AIDS defining illnesses, including d