scholarly journals A Lower CD4 Count Predicts Most Causes of Death except Cardiovascular Deaths. The Austrian HIV Cohort Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12532
Author(s):  
Gisela Leierer ◽  
Armin Rieger ◽  
Brigitte Schmied ◽  
Mario Sarcletti ◽  
Angela Öllinger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Diseases ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Observation Time ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Cd4 Counts ◽  
Period 2 ◽  
All Cause Mortality

(1) Objective: To investigate changes in mortality rates and predictors of all-cause mortality as well as specific causes of death over time among HIV-positive individuals in the combination antiretroviral therapy (cART) era. (2) Methods: We analyzed all-cause as well as cause-specific mortality among the Austrian HIV Cohort Study between 1997 and 2014. Observation time was divided into five periods: Period 1: 1997–2000; period 2: 2001–2004; period 3: 2005–2008; period 4: 2009–2011; and period 5: 2012–2014. Mortality rates are presented as deaths per 100 person-years (d/100py). Potential risk factors associated with all-cause mortality and specific causes of death were identified by using multivariable Cox proportional hazard models. Models were adjusted for time-updated CD4, age and cART, HIV transmission category, population size of residence area and country of birth. To assess potential nonlinear associations, we fitted all CD4 counts per patient using restricted cubic splines with truncation at 1000 cells/mm3. Vital status of patients was cross-checked with death registry data. (3) Results: Of 6848 patients (59,704 person-years of observation), 1192 died: 380 (31.9%) from AIDS-related diseases. All-cause mortality rates decreased continuously from 3.49 d/100py in period 1 to 1.40 d/100py in period 5. Death due to AIDS-related diseases, liver-related diseases and non-AIDS infections declined, whereas cardiovascular diseases as cause of death remained stable (0.27 d/100py in period 1, 0.10 d/100py in period 2, 0.16 d/100py in period 3, 0.09 d/100py in period 4 and 0.14 d/100py in period 5) and deaths due to non-AIDS-defining malignancies increased. Compared to latest CD4 counts of 500 cells/mm3, lower CD4 counts conferred a higher risk of deaths due to AIDS-related diseases, liver-related diseases, non-AIDS infections and non-AIDS-defining malignancies, whereas no significant association was observed for cardiovascular mortality. Results were similar in sensitivity analyses where observation time was divided into two periods: 1997–2004 and 2005–2014. (4) Conclusion: Since the introduction of cART, risk of death decreased and causes of death changed. We do not find evidence that HIV-positive individuals with a low CD4 count are more likely to die from cardiovascular diseases.

1603-P: Changes in Age- and Gender-Specific All-Cause Mortality Rates and Ratios in People with T2DM in Hungary between 2001-2016: A Nationwide Cohort Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1603-P
Author(s):  
GYORGY JERMENDY ◽  
ZOLTAN KISS ◽  
GYÖRGY ROKSZIN ◽  
IBOLYA FÁBIÁN ◽  
ISTVAN WITTMANN ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rates ◽  
Age And Gender ◽  
All Cause Mortality ◽  
And Gender ◽  
Gender Specific

scholarly journals Follow-up of incidental pulmonary nodules and association with mortality in a safety-net cohort

Diagnosis ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 351-359 ◽  
Author(s):  
Jonathan S. Lee ◽  
Sarah Lisker ◽  
Eric Vittinghoff ◽  
Roy Cherian ◽  
David B. McCoy ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Pulmonary Nodules ◽  
Safety Net ◽  
Mortality Rates ◽  
All Cause Mortality ◽  
Multivariable Models

Abstract Background Though incidental pulmonary nodules are common, rates of guideline-recommended surveillance and associations between surveillance and mortality are unclear. In this study, we describe adherence (categorized as complete, partial, late and none) to guideline-recommended surveillance among patients with incidental 5–8 mm pulmonary nodules and assess associations between adherence and mortality. Methods This was a retrospective cohort study of 551 patients (≥35 years) with incidental pulmonary nodules conducted from September 1, 2008 to December 31, 2016, in an integrated safety-net health network. Results Of the 551 patients, 156 (28%) had complete, 87 (16%) had partial, 93 (17%) had late and 215 (39%) had no documented surveillance. Patients were followed for a median of 5.2 years [interquartile range (IQR), 3.6–6.7 years] and 82 (15%) died during follow-up. Adjusted all-cause mortality rates ranged from 2.24 [95% confidence interval (CI), 1.24–3.25] deaths per 100 person-years for complete follow-up to 3.30 (95% CI, 2.36–4.23) for no follow-up. In multivariable models, there were no statistically significant associations between the levels of surveillance and mortality (p > 0.16 for each comparison with complete surveillance). Compared with complete surveillance, adjusted mortality rates were non-significantly increased by 0.45 deaths per 100 person-years (95% CI, −1.10 to 2.01) for partial, 0.55 (95% CI, −1.08 to 2.17) for late and 1.05 (95% CI, −0.35 to 2.45) for no surveillance. Conclusions Although guideline-recommended surveillance of small incidental pulmonary nodules was incomplete or absent in most patients, gaps in surveillance were not associated with statistically significant increases in mortality in a safety-net population.

scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

2020 ◽  
Author(s):  
Karin Modig ◽  
Anders Ahlbom ◽  
Marcus Ebeling
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
Death Rates ◽  
Excess Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

scholarly journals Trans-abdominal ultrasonic findings correlated with CD4+ counts in adult HIV-infected patients in Benin, Nigeria

2009 ◽  
Vol 13 (2) ◽  
pp. 34 ◽  
Author(s):  
B O-E Igbinedion ◽  
T T Marchie ◽  
E Ogbeide
Keyword(s):  
Abdominal Ultrasound ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Abdominal Ultrasonography ◽  
Cd4 Counts ◽  
Splenic Parenchyma ◽  
Ultrasound Findings ◽  
The Common ◽  
Classification Index ◽  
The University

Objective: The objective of this study is to document the abdominal ultrasound findings in HIV infected patients and compare it with their CD4+ count. Patients and method: 300 confirmed HIV positive patients had abdominal ultrasonography done at the University of Benin Teaching Hospital from November 2007 to January 2008. Each patient’s sonographic findings were correlated with their CD4+ category using the WHO’s HIV classification index. Result: Splenomegaly, hepatomegaly, renomegaly, hyperechoic splenic parenchyma, increased renal echogenicity and lymphadenopathy are among the common sonographic findings. However, few of these findings correlated statistically with the CD4+ count. Conclusion: The versatile diagnostic tool, ultrasound, should continue to be an important imaging equipment in several impoverished communities. In the evaluation of HIV infected patients, its use is invaluable and should be promoted.

scholarly journals Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

2015 ◽  
Vol 9 (01) ◽  
pp. 060-069 ◽  
Author(s):  
Nermin Kamal Saeed ◽  
Eman Farid ◽  
Afaf E Jamsheer
Keyword(s):  
Bacterial Infections ◽  
Opportunistic Infections ◽  
Arab World ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Cd4 Counts ◽  
Significant Difference ◽  
Streptococcus Milleri ◽  
Mycobacteria Other Than Tuberculosis

Introduction: This study aimed to examine the prevalence of opportunistic infections in HIV-infected patients in Bahrain and its relation to absolute CD4 count, CD4%, and CD4/CD8 ratio. Methodology: This retrospective cohort study used laboratory records (January 2009 - May 2013) from a major hospital in Bahrain. Opportunistic infections (OIs); absolute CD4 counts, CD4%, and CD4/CD8 ratio were recorded. Results: CD4% and absolute CD4 count in HIV patients with associated infections (157 ± 295) was significantly lower than in those without associated infections (471 ± 285) (p < 0.001). There was no significant difference in CD4/CD8 ratio between the two groups. Infection with Staphylococcus aureus was the commonest infection, present in 9.8% of total HIV-infected patients and 28.7% of members of the AIDS patient group with OIs, followed by yeast infections (9.2% and 27.2%, respectively). Mycobacterium tuberculosis was present in 3.6% of total HIV-infected patients and 10.6% of the group with OIs, while mycobacteria other than tuberculosis (MOTT) was present in 2.5% and 7.5%, respectively. Pneumocystis jirovecii pneumonia (PCP) was observed in 5.1% and 15.1%, respectively. Herpes simplex II (HSV-II) was observed in 3% and 9%, respectively, while Cytomegalovirus antigenemia was only present in 2% and 6%, respectively. Streptococcus pneumoniae, Streptococcus milleri, Stenotrophomonas maltophilia, and Citrobacter species were bacterial infections observed least frequently. Conclusions: Studying the pattern of OIs in HIV-infected patients in Bahrain is of paramount importance due to the scarcity of data in the Arab world. This will help to improve physicians’ awareness to improve care of HIV-infected patients.

Cervical cancer in patients infected with human immunodeficiency virus (HIV)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5544-5544
Author(s):  
M. M. Leitao ◽  
P. White ◽  
B. M. Cracchiolo
Keyword(s):  
Cervical Cancer ◽  
Highly Active Antiretroviral Therapy ◽  
Invasive Cervical Cancer ◽  
Cd4 Count ◽  
University Hospital ◽  
Smoking History ◽  
Hiv Positive ◽  
Hiv Viral Load ◽  
Cd4 Counts ◽  
Highly Active

5544 Background: The objective of this study was to compare the HIV viral load (VL), and CD4 counts (CD4) in patients infected with HIV with and without cervical cancer. We hypothesize that HIV positive women with inadequate HIV control, as reflected by the degree of immune suppression, will be at the highest risk of developing cervical cancer. Methods: We performed a case-control study of all patients seen at University Hospital from 1/1/95 - 4/30/06. All patients were HIV positive and were identified using an institutional electronic patient database and University Hospital Cancer Registry using ICD-9 codes. Cases were patients diagnosed with invasive cervical cancer and controls were patients without invasive cervical cancer. Patients were used as a control if there was documentation of a normal gynecologic exam without clinical or histopathologic evidence of cervical cancer. CD4 counts and viral loads were then abstracted from the electronic medical chart. Patients were kept as cases or controls if they had a CD4 count <6 months before or <1 month after the diagnosis of invasive cervical cancer (cases) or from the last gynecologic exam (controls). Controls were matched to cases on a 4:1 ratio according to current smoking history. Patients were considered immunocompetent if they had both CD4 counts >200 and VL <10,000. SPSS version 12.0 statistical software was used to analyze our data. Results: A total of 15 cases and 60 controls were identified. The majority (67 [89%]) of patients were African-American. The median CD4 count for the cases was 208 (range 18 - 1102) compared to 445 (range 20 - 1201) for the controls (p=0.03). The median VL was 16,918 (range 50 - 214,915) for the cases compared to 1,430 (range 50 - 571,000) for the controls (p=0.15). Only one (7.1%) of 14 cases was immunocompetent compared to 35 (63.6%) of 55 controls (OR 0.04 [95% CI: 0, 0.37; p<0.001]). This significance was maintained after adjusting for current highly active antiretroviral therapy (HAART) use, number of years known to be HIV infected, and patient age (p=0.002). Conclusions: Patients with HIV who are diagnosed with invasive cervical cancer appear to have a much greater degree of immunosuppression than women with HIV without invasive cervical cancer. No significant financial relationships to disclose.

scholarly journals Spectrum Of Chest X-Ray Findings Among Human Immunodeficiency Virus Positive Individuals In A Nigerian Tertiary Hospital

2014 ◽  
Vol 10 (2) ◽  
pp. 27-34 ◽  
Author(s):  
Rachael Adeyanju Akinola ◽  
TM Balogun ◽  
AA Adeniyi ◽  
JAA Onakoya ◽  
IO Fabeyibi
Keyword(s):  
Immune System ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
University Teaching ◽  
Hiv Positive ◽  
X Rays ◽  
Cd4 Counts ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray

Introduction: Human immunodefi ciency virus infection damages the immune system making those affected more susceptible to opportunistic infections and malignancies which are common in the chest. This study sought to determine the pattern of chest X-ray lesions and the corresponding CD4 counts of HIV positive patients reporting in the antiretroviral clinic of this teaching hospital for the fi rst time. Methodology: Consecutive HIV positive patients that attended the antiretroviral clinic of the Lagos State University Teaching Hospital, (LASUTH) from September 2009 to January 2011 were recruited. Their chest x-rays were assessed for the presence of pulmonary lesions and baseline CD 4 counts were done to assess their degree of immunosuppression. Data were analyzed using the Statistical Package for Social Sciences, version 16.0. Results: There were 211 subjects, 151 females and 60 males with a M:F ratio of 1:2.5 The mean age of participants was 36.5±11.9. Mean baseline CD4 count for the subjects was 279±220.7 cells/mm3. Almost two thirds (64.9%) cases had normal chest x-rays with their mean CD4 count as 277.65±228.54 cells/mm3. The commonest lesions seen in the lungs include pulmonary infi ltrations, 55 (26.1%), cardiomegaly, 24 (11.4%), pulmonary consolidation, 21 (10%) and lymphadenopathy, 14 (6.6%). The commonest radiological diagnosis made were Atypical pneumonitis, 39 (18.5%), pulmonary TB, 13 (6.2%), pneumonia 13 (6.2%) and cardiomegaly13 (6.2%) respectively.Patients with chest findings had lower mean CD4 counts, 239 cells/mm3 when compared to those without, 244 cells/mm3. Conclusion: Pulmonary infiltration was the commonest lesion, while the commonest diagnosis was atypical pneumonitis. Patients with chest x-ray lesions were found to have lower CD4 counts with probable worse destruction of their immune system. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 27-34 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9710

Differences in Mortality Rates and Causes of Death between HIV Positive and HIV Negative Intravenous Drug Users

1993 ◽  
Vol 22 (2) ◽  
pp. 315-320 ◽  
Author(s):  
ANNE ESKILD ◽  
PER MAGNUS ◽  
SVEN OVE SAMUELSEN ◽  
CHRISTIAN SOHLBERG ◽  
PETER KITTELSEN
Keyword(s):  
Drug Users ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Intravenous Drug ◽  
Hiv Positive ◽  
Intravenous Drug Users ◽  
Hiv Negative

scholarly journals Causes of Death of Professional Musicians in the Classical Genre

2019 ◽  
Vol 34 (2) ◽  
pp. 92-97 ◽  
Author(s):  
Tuire Kuusi ◽  
Jari Haukka ◽  
Liisa Myllykangas ◽  
Irma Järvelä
Keyword(s):  
Early Childhood ◽  
Cardiovascular Diseases ◽  
Neurodegenerative Diseases ◽  
Causes Of Death ◽  
Professional Musicians ◽  
Performing Artists ◽  
Music Practice ◽  
All Cause Mortality ◽  
Icd 10 ◽  
Standardized Mortality Ratios

OBJECTIVE: Music practice and listening have been reported to have favorable effects on human health, but empirical data are largely missing about these effects. To obtain more information about the effect of exposure to music from early childhood, we examined the causes of death of professional musicians in the classical genre. METHODS: We used standardized mortality ratios (SMR) for Finnish performing artists (n=5,780) and church musicians (n=22,368) during 1981-2016. We examined deaths from cardiovascular diseases, cancers, and neurodegenerative and alcohol-related diseases. The diagnoses were based on the ICD-10, with data obtained from Statistics of Finland. RESULTS: Overall, SMR for all-cause mortality was 0.59 (95% CI 0.57–0.61) for church musicians and 0.75 (95% CI 0.70–0.80) for performing artists, suggesting a protective effect of music for health. In contrast, we found increased mortality in alcohol-related diseases among female performing artists (SMR 1.85, 95% CI 1.06–2.95) and in neurodegenerative diseases among male performing artists (1.46, 95% CI 1.13–1.84). Additionally, we found higher SMRs for female than male church musicians for cancers (SMRfemales 0.90, 95% CI 0.83–0.97; SMRmales 0.60, 95% CI 0.54–0.67) and cardiovascular diseases (SMRfemales 0.75, 95% CI 0.68–0.82; SMRmales 0.58, 95% CI 0.54–0.64). CONCLUSIONS: Our results show that the causes of death in performers differ from those in church musicians. Performing artists are not protected from neurodegenerative diseases or alcohol-related deaths. The findings call for further study on the life-long effects of music in musicians.

scholarly journals Outcomes of Reflex Cryptococcal Antigen (CrAg) Screening in Human Immunodeficiency Virus (HIV)-Positive Patients With CD4 Counts of 100–200 Cells/µL in Botswana

2020 ◽  
Author(s):  
Mark W Tenforde ◽  
Thandi Milton ◽  
Ikanyeng Rulaganyang ◽  
Charles Muthoga ◽  
Leabaneng Tawe ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Fold Increase ◽  
Cd4 Count ◽  
Hiv Positive ◽  
Cd4 Counts ◽  
Cryptococcal Antigen ◽  
Immunodeficiency Virus

Abstract Increasing the CD4-count threshold for cryptococcal antigen (CrAg) screening from ≤100 to ≤200 cells/µL resulted in a 3-fold increase in numbers screened. CrAg-prevalence was 3.5% at CD4 101–200 and 6.2% ≤100 cells/µL. Six-month mortality was 21.4% (9/42) in CrAg-positive CD4 ≤100 cells/µL and 3.2% (1/31) in CrAg-positive CD4 101–200 cells/µL.

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