2010年法国HIV感染患者的死因（全国性调查）：自2000年以来的趋势
Causes of death among HIV-infected patients in France in 2010 (national survey): trends since 2000.
作者信息
Morlat Philippe, Roussillon Caroline, Henard Sandrine, Salmon Dominique, Bonnet Fabrice, Cacoub Patrice, Georget Aurore, Aouba Albertine, Rosenthal Eric, May Thierry, Chauveau Marie, Diallo Bilghissa, Costagliola Dominique, Chene Geneviève
机构信息
aINSERM, ISPED, Centre INSERM U897-Epidémiologie-Biostatistiques bService de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, CHU de Bordeaux cUniversity Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistiques, Bordeaux dService de Maladies Infectieuses, Hôpital Brabois, Vandoeuvre-Les-Nancy eUnité de Pathologie Infectieuse, Pôle Médecine, Hôpital Cochin, AP-HP fUniversité Paris Descartes gDepartment of Internal Medicine and Immunology, AP-HP Hôpital La Pitié-Salpêtrière hDépartement Hospitalo-universitaire I2B, UPMC Univ Paris 06, UMR 7211, Paris iINSERM-CépiDC, Le Kremlin-Bicêtre jService de Médecine Interne, Hôpital de l'Archet kUniversité de Nice-Sophia Antipolis, Nice lService des Maladies Infectieuses et Tropicales, Hôpital Purpan, Toulouse mService des Maladies Infectieuses et Tropicales, Hôpitaux Universitaires Paris Nord Val de Seine nUniversité Paris 7 oINSERM, UMR-S 1136 pSorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Paris qCHU de Bordeaux, Pole de Santé Publique, Bordeaux, France.
出版信息
AIDS. 2014 May 15;28(8):1181-91. doi: 10.1097/QAD.0000000000000222.
OBJECTIVE
The Mortalité 2010 survey aimed at describing the causes of death among HIV-infected patients in France in 2010 and their evolution since 2000.
DESIGN AND METHODS
A national sample of clinical sites, providing HIV care and treatment, notified and documented deaths using a standardized questionnaire.
RESULTS
The 90 participating wards notified 728 deaths. Median age at death was 50 years (interquartile range 45-58) and 75% were men. The main underlying causes of death were AIDS-related (25% in 2010 vs. 36% in 2005 and 47% in 2000), non-AIDS non-viral hepatitis-related malignancy (22 vs. 17 and 11%), liver-related (11 vs. 15 and 13%), cardiovascular diseases (10 vs. 8 and 7%) and non-AIDS-related infections (9 vs. 4 and 7%). Malignancies (AIDS and non-AIDS-related) accounted for a third of all causes of death. AIDS accounted for 33% of all causes of death among patients mono-infected with HIV vs. only 13% among those co-infected with hepatitis B virus or hepatitis C virus.
CONCLUSION
In 2010, 25% of the causes of death among HIV-infected patients remained AIDS-related. Improved screening and earlier HIV treatment should lead to a smaller proportion of deaths due to AIDS. The majority of patients died of various causes, whereas their HIV infection was well controlled under treatment. Improving case management of HIV-infected patients should include a multidisciplinary approach (prevention, screening, treatment), especially in oncology. Smoking cessation should be a priority goal.
目的
“2010年死亡率”调查旨在描述2010年法国艾滋病毒感染患者的死亡原因及其自2000年以来的演变情况。
设计与方法
一个提供艾滋病毒护理和治疗的全国临床站点样本，使用标准化问卷报告并记录死亡情况。
结果
90个参与病房报告了728例死亡。死亡年龄中位数为50岁（四分位间距45 - 58岁），75%为男性。主要潜在死亡原因是艾滋病相关（2010年为25%，2005年为36%，2000年为47%）、非艾滋病非病毒性肝炎相关恶性肿瘤（22%对17%和11%）、肝脏相关（11%对15%和13%）、心血管疾病（10%对8%和7%）以及非艾滋病相关感染（9%对4%和7%）。恶性肿瘤（艾滋病相关和非艾滋病相关）占所有死亡原因的三分之一。艾滋病占艾滋病毒单一感染患者所有死亡原因的33%，而在同时感染乙型肝炎病毒或丙型肝炎病毒的患者中仅占13%。
结论
2010年，艾滋病毒感染患者中25%的死亡原因仍与艾滋病相关。改进筛查和更早开始艾滋病毒治疗应会使因艾滋病导致的死亡比例降低。大多数患者死于各种原因，而他们的艾滋病毒感染在治疗下得到了良好控制。改善艾滋病毒感染患者的病例管理应包括多学科方法（预防、筛查、治疗），尤其是在肿瘤学方面。戒烟应是首要目标。
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