巴西东北部一个队列中艾滋病毒感染者的生存和死亡率概况。
Survival and mortality profile among people living with HIV in a cohort in the Northeastern region of Brazil.
作者信息
Leite Kaliene Maria Estevão, Lima Kledoaldo Oliveira, Ximenes Ricardo Arraes de Alencar, Albuquerque Maria de Fatima Militão de, Miranda-Filho Demócrito de Barros, Godoi Emmanuelle Tenório Albuquerque Madruga, Montarroyos Ulisses Ramos, Lacerda Heloísa Ramos
机构信息
Universidade Federal de Pernambuco, Pós-Graduação em Medicina Tropical, Recife, Pernambuco, Brazil.
Universidade Federal de Pernambuco, Hospital das Clínicas, Recife, Pernambuco, Brazil.
出版信息
Rev Inst Med Trop Sao Paulo. 2024 Apr 19;66:e23. doi: 10.1590/S1678-9946202466023. eCollection 2024.
Conditions related to the acquired immune deficiency syndrome (AIDS) are still a significant cause of morbidity and mortality among people living with HIV (PLHIV). Longer survival in this population were reported to increase the risk of developing noncommunicable chronic diseases (NCDs). This study aimed to estimate the survival and causes of death according to age group and sex among PLHIV monitored at two referral centers in the Northeastern Brazil. This is a prospective, retrospective cohort with death records from 2007 to 2018, based on a database that registers causes of death using the International Classification of Disease (ICD-10), which were subsequently coded following the Coding Causes of Death in HIV (CoDe). A total of 2,359 PLHIV participated in the study, with 63.2% being men, with a follow-up period of 13.9 years. Annual mortality rate was 1.46 deaths per 100 PLHIV (95% CI: 1.33 - 1.60) with a frequency of 20.9%. Risk of death for men increased by 49% when compared to women, and the risk of death in PLHIV increased by 51% among those aged 50 years and over at the time of diagnosis. It was observed that 73.5% accounted for AIDS-related deaths, 6.9% for non-AIDS defining cancer, 6.3% for external causes, and 3.2% for cardiovascular diseases. Among the youngest, 97.2% presented an AIDS-related cause of death. Highest frequency of deaths from neoplasms was among women and from external causes among men. There is a need for health services to implement strategies ensuring greater adherence to treatment, especially among men and young people. Moreover, screening for chronic diseases and cancer is essential, including the establishment of easily accessible multidisciplinary care centers that can identify and address habits such as illicit drug use and alcoholism, which are associated with violent deaths.
与获得性免疫缺陷综合征(艾滋病)相关的病症仍然是艾滋病毒感染者(PLHIV)发病和死亡的重要原因。据报道,该人群的较长生存期会增加患非传染性慢性病(NCDs)的风险。本研究旨在估计巴西东北部两个转诊中心监测的PLHIV按年龄组和性别的生存率及死亡原因。这是一项前瞻性、回顾性队列研究,基于一个使用国际疾病分类(ICD - 10)登记死亡原因的数据库,该数据库随后按照艾滋病毒死亡原因编码(CoDe)进行编码,纳入了2007年至2018年的死亡记录。共有2359名PLHIV参与了该研究,其中63.2%为男性,随访期为13.9年。年死亡率为每100名PLHIV中有1.46例死亡(95%置信区间:1.33 - 1.60),频率为20.9%。与女性相比,男性的死亡风险增加了49%,在诊断时年龄在50岁及以上的PLHIV中,死亡风险增加了51%。据观察,73.5%的死亡是由艾滋病相关原因导致的,6.9%是由非艾滋病定义的癌症导致的,6.3%是由外部原因导致的,3.2%是由心血管疾病导致的。在最年轻的人群中,97.2%的死亡是由艾滋病相关原因导致的。肿瘤导致的死亡频率在女性中最高,而外部原因导致的死亡频率在男性中最高。卫生服务机构需要实施策略,确保更好地坚持治疗,特别是在男性和年轻人中。此外,慢性病和癌症筛查至关重要,包括建立易于获得的多学科护理中心,以识别和解决与暴力死亡相关的非法药物使用和酗酒等习惯。