Time Trends in Causes of Death in People With HIV: Insights From the Swiss HIV Cohort Study

Overview

Journal Clin Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2024 Jan 12

PMID 38214897

Authors

M S R Weber

J J Duran Ramirez

M Hentzien

M Cavassini

E Bernasconi

E Hofmann

H Furrer

H Kovari

M Stockle

P Schmid

D Haerry

D L Braun

H F Gunthard

K Kusejko

Affiliations

Soon will be listed here.

Abstract

Background: Advancements in access to antiretroviral therapy (ART) and human immunodeficiency virus (HIV) care have led to a decline in AIDS-related deaths among people with HIV (PWH) in Switzerland. However, data on the ongoing changes in causes of death among PWH over the past 15 years are scarce.

Methods: We investigated all reported deaths in the Swiss HIV Cohort Study between 2005 and 2022. Causes of death were categorized using the Coding Causes of Death in HIV protocol. The statistical analysis included demographic stratification to identify time trends and logistic regression models to determine associated factors for the underlying cause of death.

Results: In total, 1630 deaths were reported, with 23.7% of individuals assigned female sex at birth. These deaths included 147 (9.0%) HIV/AIDS-related deaths, 373 (22.9%) due to non-AIDS, non-hepatic cancers, 166 (10.2%) liver-related deaths, and 158 (9.7%) cardiovascular-related deaths. The median age at death (interquartile range) increased from 45.0 (40.0-53.0) years in 2005-2007 to 61.0 (56.0-69.5) years in 2020-2022. HIV/AIDS- and liver-related deaths decreased, whereas deaths from non-AIDS, non-hepatic cancers increased and cardiovascular-related deaths remained relatively stable.

Conclusions: The proportionally decreasing HIV/AIDS and liver-related deaths showcase the effectiveness of ART, comprehensive HIV patient care, and interventions targeting hepatitis C virus coinfection. Future research should focus on managing cancer and cardiovascular-related conditions as the new leading causes of death among PWH. Comprehensive healthcare strategies focusing on non-AIDS-related comorbid conditions, cancer management, and sustaining liver and cardiovascular health are needed to bridge the ongoing health disparities between PWH and the general population.

Citing Articles

Deciphering the Association: Critical HDL-C Levels and Their Impact on the Glycation Gap in People Living with HIV.

Anaya-Ambriz E, Alvarez-Zavala M, Gonzalez-Hernandez L, Andrade-Villanueva J, Zuniga-Quinones S, Valle-Rodriguez A Int J Mol Sci. 2025; 26(3).

PMID: 39940683 PMC: 11817432. DOI: 10.3390/ijms26030914.

No accelerated progression of subclinical atherosclerosis with integrase strand transfer inhibitors compared to non-nucleoside reverse transcriptase inhibitors.

Garcia-Abellan J, Garcia J, Padilla S, Fernandez-Gonzalez M, Agullo V, Mascarell P J Antimicrob Chemother. 2024; 80(1):126-137.

PMID: 39450853 PMC: 11695909. DOI: 10.1093/jac/dkae383.

A cascade of care for diabetes in people living with HIV in a tertiary care center in Mexico City.

Espejo-Ortiz C, Sierra-Barajas N, Silva-Casarrubias A, Guerrero-Torres L, Caro-Vega Y, Serrano-Pinto Y HIV Res Clin Pract. 2024; 25(1):2411481.

PMID: 39377112 PMC: 11805464. DOI: 10.1080/25787489.2024.2411481.

Increased incidence of diabetes in people living with HIV treated with first-line integrase strand transfer inhibitors: A French multicentre retrospective study.

Ursenbach A, Sireyjol A, Delpierre C, Duvivier C, Hocqueloux L, Rey D HIV Med. 2024; 26(1):166-172.

PMID: 39197859 PMC: 11725413. DOI: 10.1111/hiv.13698.

Cancer in People with HIV.

Odeny T, Fink V, Muchengeti M, Gopal S Infect Dis Clin North Am. 2024; 38(3):531-557.

PMID: 39111924 PMC: 11529824. DOI: 10.1016/j.idc.2024.06.007.

References

Glass T, Gunthard H, Calmy A, Bernasconi E, Scherrer A, Battegay M . The Role of Human Immunodeficiency Virus (HIV) Asymptomatic Status When Starting Antiretroviral Therapy on Adherence and Treatment Outcomes and Implications for Test and Treat: The Swiss HIV Cohort Study. Clin Infect Dis. 2020; 72(8):1413-1421. DOI: 10.1093/cid/ciaa239. View

Marzel A, Kouyos R, Reinschmidt S, Balzer K, Garon F, Spitaleri M . Dietary Patterns and Physical Activity Correlate With Total Cholesterol Independently of Lipid-Lowering Drugs and Antiretroviral Therapy in Aging People Living With Human Immunodeficiency Virus. Open Forum Infect Dis. 2018; 5(4):ofy067. PMC: 5905359. DOI: 10.1093/ofid/ofy067. View

Santos J, Souza J, Valente J, Alonso V, Ramalho A, Viana J . The state of health in the European Union (EU-28) in 2017: an analysis of the burden of diseases and injuries. Eur J Public Health. 2019; 30(3):573-578. DOI: 10.1093/eurpub/ckz203. View

Sabin C, Worm S . Conventional cardiovascular risk factors in HIV infection: how conventional are they?. Curr Opin HIV AIDS. 2009; 3(3):214-9. DOI: 10.1097/COH.0b013e3282f6a613. View

Kusejko K, Salazar-Vizcaya L, Shah C, Stockle M, Beguelin C, Schmid P . Sustained Effect on Hepatitis C Elimination Among Men Who Have Sex With Men in the Swiss HIV Cohort Study: A Systematic Re-Screening for Hepatitis C RNA Two Years Following a Nation-Wide Elimination Program. Clin Infect Dis. 2022; 75(10):1723-1731. DOI: 10.1093/cid/ciac273. View

Thompson M, Aberg J, Cahn P, Montaner J, Rizzardini G, Telenti A . Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA. 2010; 304(3):321-33. DOI: 10.1001/jama.2010.1004. View

Bachofner J, Valli P, Bergamin I, Kroger A, Kunzler P, Baserga A . Excellent outcome of direct antiviral treatment for chronic hepatitis C in Switzerland. Swiss Med Wkly. 2018; 148:w14560. DOI: 10.4414/smw.2018.14560. View

Sabin C, Reiss P . Epidemiology of ageing with HIV: what can we learn from cohorts?. AIDS. 2017; 31 Suppl 2:S121-S128. DOI: 10.1097/QAD.0000000000001374. View

Lohse N, Hansen A, Pedersen G, Kronborg G, Gerstoft J, Sorensen H . Survival of persons with and without HIV infection in Denmark, 1995-2005. Ann Intern Med. 2007; 146(2):87-95. DOI: 10.7326/0003-4819-146-2-200701160-00003. View

10.

Beguelin C, Suter A, Bernasconi E, Fehr J, Kovari H, Bucher H . Trends in HCV treatment uptake, efficacy and impact on liver fibrosis in the Swiss HIV Cohort Study. Liver Int. 2017; 38(3):424-431. DOI: 10.1111/liv.13528. View

11.

Gueler A, Moser A, Calmy A, Gunthard H, Bernasconi E, Furrer H . Life expectancy in HIV-positive persons in Switzerland: matched comparison with general population. AIDS. 2016; 31(3):427-436. PMC: 5302412. DOI: 10.1097/QAD.0000000000001335. View

12.

Farahani M, Mulinder H, Farahani A, Marlink R . Prevalence and distribution of non-AIDS causes of death among HIV-infected individuals receiving antiretroviral therapy: a systematic review and meta-analysis. Int J STD AIDS. 2016; 28(7):636-650. DOI: 10.1177/0956462416632428. View

13.

Smith C, Sabin C, Lundgren J, Thiebaut R, Weber R, Law M . Factors associated with specific causes of death amongst HIV-positive individuals in the D:A:D Study. AIDS. 2010; 24(10):1537-48. DOI: 10.1097/QAD.0b013e32833a0918. View

14.

Trickey A, May M, Gill M, Grabar S, Vehreschild J, Wit F . Cause-specific mortality after diagnosis of cancer among HIV-positive patients: A collaborative analysis of cohort studies. Int J Cancer. 2020; 146(11):3134-3146. PMC: 7187452. DOI: 10.1002/ijc.32895. View

15.

Bohlius J, Schmidlin K, Costagliola D, Fatkenheuer G, May M, Caro-Murillo A . Incidence and risk factors of HIV-related non-Hodgkin's lymphoma in the era of combination antiretroviral therapy: a European multicohort study. Antivir Ther. 2009; 14(8):1065-74. PMC: 2821596. DOI: 10.3851/IMP1462. View

16.

Hasse B, Ledergerber B, Furrer H, Battegay M, Hirschel B, Cavassini M . Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis. 2011; 53(11):1130-9. DOI: 10.1093/cid/cir626. View

17.

Vermeulen M, van Schalkwyk C, Jacobs G, van den Berg K, Stone M, Bakkour S . The Impact of Early Antiretroviral Treatment (ART) for HIV on the Sensitivity of the Latest Generation of Blood Screening and Point of Care Assays. Viruses. 2022; 14(7). PMC: 9324335. DOI: 10.3390/v14071426. View

18.

Sun F, Franks K, Murray L, Lilley J, Wheller B, Banfill K . Cardiovascular mortality and morbidity following radical radiotherapy for lung cancer: Is cardiovascular death under-reported?. Lung Cancer. 2020; 146:1-5. DOI: 10.1016/j.lungcan.2020.05.004. View

19.

Wandeler G, Gsponer T, Bregenzer A, Gunthard H, Clerc O, Calmy A . Hepatitis C virus infections in the Swiss HIV Cohort Study: a rapidly evolving epidemic. Clin Infect Dis. 2012; 55(10):1408-16. DOI: 10.1093/cid/cis694. View

20.

Douglas P, Umbleja T, Bloomfield G, Fichtenbaum C, Zanni M, Overton E . Cardiovascular Risk and Health Among People With Human Immunodeficiency Virus (HIV) Eligible for Primary Prevention: Insights From the REPRIEVE Trial. Clin Infect Dis. 2021; 73(11):2009-2022. PMC: 8664454. DOI: 10.1093/cid/ciab552. View