Giacomelli Andrea, Lanini Simone, De Vito Andrea, De Benedittis Sara, Mazzitelli Maria, Ceccarelli Manuela, Gagliardini Roberta, Madeddu Giordano, Quiros-Roldan Eugenia, Girardi Enrico, Checchi Davide, Lapadula Giuseppe, Tascini Carlo, Tavelli Alessandro, Antinori Andrea, d'Arminio Monforte Antonella
III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Milan, Italy.
Department of Biomedical and Clinical Sciences, Università Degli Studi di Milano, Milan, Italy.
Open Forum Infect Dis. 2025 Aug 2;12(8):ofaf455. doi: 10.1093/ofid/ofaf455. eCollection 2025 Aug.
Understanding the evolution and dynamics of deaths in people with HIV (PWH) is crucial to tailor interventions aiming at improving PWH long-term well-being. We aimed to assess all-cause and cause-specific mortality in PWH in Italy.
PWH enrolled before antiretroviral start from Icona cohort (78 Italian HIV clinics) between 1997 and 2021 (last observation December 2022) were included. Mortality was reported as incidence rate per 100 person-years of follow-up (PYFU). The mortality incidence rate according to calendar period was estimated by Poisson regression model.
Overall, 17,006 PWH were included of whom 1584 (9.31%) died. The highest mortality rates were observed during the earliest calendar periods, with 2.67 (95% CI: 2.19-3.25) and 1.93 (95% CI: 1.67-2.22) deaths per 100 PYFU in 1997-1998 and 1999-2001, respectively. After 2010, mortality rates fell below 1 per 100 PYFU, reaching 0.74 (95% CI: 0.65-0.84) and 0.71 (95% CI: 0.63-0.80) in 2017-2019 and 2020-2022, respectively. A significant drop was observed for AIDS-related mortality in the first two periods from 1.45 (95% CI: 1.11-1.90) in 1997-1998 to 0.78 (95% CI: 0.62-0.97) deaths per 100 PYFU in 1999-2001. AIDS-related mortality continued to decrease in the subsequent years, with the lowest rate observed in the last two calendar periods: 0.10 (95% CI: 0.07-0.14) deaths per 100 person-years in 2017-2019 and 0.10 (95% CI: 0.08-0.15) deaths per 100 person-years in 2020-2022.
All-cause mortality in PWH in Italy significantly decreased over time, mainly for a reduction in AIDS-related mortality.
了解艾滋病毒感染者（PWH）死亡情况的演变和动态对于制定旨在改善PWH长期健康状况的干预措施至关重要。我们旨在评估意大利PWH的全因死亡率和特定病因死亡率。
纳入1997年至2021年（最后观察时间为2022年12月）期间从伊科纳队列（78家意大利艾滋病毒诊所）中在开始抗逆转录病毒治疗前入组的PWH。死亡率报告为每100人年随访（PYFU）的发病率。根据日历期的死亡率发病率通过泊松回归模型进行估计。
总体而言，共纳入17,006名PWH，其中1584人（9.31%）死亡。在最早的日历期观察到最高死亡率，1997 - 1998年和1999 - 2001年每100 PYFU的死亡率分别为2.67（95% CI：2.19 - 3.25）和1.93（95% CI：1.67 - 2.22）。2010年后，死亡率降至每100 PYFU低于1，在2017 - 2019年和2020 - 2022年分别达到0.74（95% CI：0.65 - 0.84）和0.71（95% CI：0.63 - 0.80）。在最初两个时期，艾滋病相关死亡率显著下降，从1997 - 1998年的每100 PYFU 1.45（95% CI：1.11 - 1.90）降至1999 - 2001年的0.78（95% CI：0.62 - 0.97）。艾滋病相关死亡率在随后几年继续下降，在最后两个日历期观察到最低率：2017 - 2019年每100人年0.10（95% CI：0.07 - 0.14）死亡，2020 - 2022年每100人年0.10（95% CI：0.08 - 0.15）死亡。
意大利PWH的全因死亡率随时间显著下降，主要是由于艾滋病相关死亡率的降低。
