HIV血清転換後の死亡リスクの変化は,一般人口の死亡率と比較したものです
Krishnan Bhaskaran1, Osamah Hamouda, Mette Sannes
1MRC Clinical Trials Unit, 222 Euston Rd, London NW1 2DA, United Kingdom. kp@ctu.mrc.ac.uk
JAMA
|July 3, 2008
まとめ
ヒト免疫不全ウイルス (HIV) 感染者の死亡率は著しく低下し,効果的な治療で一般人口のレベルに近づいています. しかし,死亡率のギャップは,感染期間が長くなると続く.
科学分野:
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
- 感染症 感染症は感染症です.
背景:
- ヒト免疫不全ウイルス (HIV) 感染者の死亡率は,治療が手頃な地域で劇的に低下しています.
- HIV感染者と一般の人々の間の死亡率のギャップは縮まっている.
研究 の 目的:
- HIVに感染した個人とHIVに感染していない一般の人々の間の死亡率のギャップの変化を時間とともに評価する.
- 高活性抗レトロウイルス療法 (HAART) が死亡率の違いに与える影響を評価する.
主な方法:
- HIVセロコンバーターコホートによるCASCADEコラボレーションのデータを活用した.
- HIV感染者における死亡率と一般人口の死亡率を比較し,人口統計学的要因に合わせて比較した.
- 1981年から2006年までの感染期間で調整された過剰死亡率の変化を分析するために,Poissonベースのモデルを使用しました.
主要な成果:
- 1000人年あたりの過剰死亡率は,1996年以前の40.8から2004-2006年の6.1に低下した.
- 過剰危険比率は1996年以前のレベルから2004年から2006年にかけて0.05に大幅に低下しました.
- 2004年から2006年にかけて,性感染症患者の血清転換後の最初の5年間,過剰な死亡率は認められませんでしたが,長期的には過剰な死亡確率が残っていました.
結論:
- HAARTの導入により,HIV感染者の死亡率が大幅に低下し,一般人口の死亡率に近付いた.
- 工業国において,性的に感染したHIV感染者は,感染後最初の5年以内に一般の人々と同様の死亡率を経験しています.
- HIV感染の期間が長くなるにつれて,持続的な過剰死亡リスクが観察されます.
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