French Audrey L, Gawel Susan H, Hershow Ronald, Benning Lorie, Hessol Nancy A, Levine Alexandra M, Anastos Kathryn, Augenbraun Michael, Cohen Mardge H
CORE Center/Stroger (Cook County) Hospital, Rush University, Chicago, IL 60612, USA.
J Acquir Immune Defic Syndr. 2009 Aug 1;51(4):399-406. doi: 10.1097/QAI.0b013e3181acb4e5.
To assess trends in mortality and cause of death for women with HIV, we studied deaths over a 10-year period among participants in the Women's Interagency HIV Study, a representative US cohort.
Deaths were ascertained by National Death Index Plus match, and causes of death determined by death certificate.
From 1995 through 2004, 710 of 2792 HIV-infected participants died. During this interval, the standardized mortality ratio fell from a high of 24.7 in 1996 to a plateau with a mean of 10.3 from 2001 to 2004. Over the decade, deaths from non-AIDS causes increased and accounted for the majority of deaths by 2001-2004. The most common non-AIDS causes of death were trauma or overdose, liver disease, cardiovascular disease, and malignancy. Independent predictors of mortality besides HIV-associated variables were depressive symptoms and active hepatitis B or C. Women who were overweight or obese were significantly less likely to die of AIDS than women of normal weight.
In the Women's Interagency HIV Study, the death rate has plateaued in recent years. Although HIV-associated factors predicted AIDS and non-AIDS deaths, other treatable conditions predicted mortality. Further gains in reducing mortality among HIV-infected women may require broader access to therapies for depression, viral hepatitis, and HIV itself.
为评估感染HIV的女性的死亡率和死因趋势，我们对美国一个具有代表性的队列研究——女性机构间HIV研究的参与者在10年期间的死亡情况进行了研究。
通过与国家死亡指数加强版匹配来确定死亡情况，并根据死亡证明确定死因。
从1995年到2004年，2792名感染HIV的参与者中有710人死亡。在此期间，标准化死亡率从1996年的高位24.7降至2001年至2004年平均为10.3的平稳水平。在这十年间，非艾滋病原因导致的死亡人数增加，到2001 - 2004年占死亡人数的大多数。最常见的非艾滋病死因是创伤或药物过量、肝病、心血管疾病和恶性肿瘤。除了与HIV相关的变量外，死亡率的独立预测因素是抑郁症状以及活动性乙型或丙型肝炎。超重或肥胖的女性死于艾滋病的可能性明显低于体重正常的女性。
在女性机构间HIV研究中，近年来死亡率已趋于平稳。虽然与HIV相关的因素可预测艾滋病和非艾滋病死亡，但其他可治疗的状况也可预测死亡率。要进一步降低感染HIV女性的死亡率，可能需要更广泛地提供针对抑郁症、病毒性肝炎和HIV本身的治疗。
