Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.

<h4>Objective</h4>To describe trends and determinants of severe morbidity in HIV-infected women and men.<h4>Design</h4>A French prospective cohort of HIV-infected patients of both sexes and all transmission categories.<h4>Methods</h4>We used hospital admission dat...

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Autores principales: Mojgan Hessamfar, Céline Colin, Mathias Bruyand, Madeleine Decoin, Fabrice Bonnet, Patrick Mercié, Didier Neau, Charles Cazanave, Jean-Luc Pellegrin, François Dabis, Philippe Morlat, Geneviève Chêne, GECSA study group
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Publicado: Public Library of Science (PLoS) 2014
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spelling oai:doaj.org-article:0090efcae14d4428a236286fcfc70b8a2021-11-25T06:06:40ZSevere morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.1932-620310.1371/journal.pone.0102671https://doaj.org/article/0090efcae14d4428a236286fcfc70b8a2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25076050/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To describe trends and determinants of severe morbidity in HIV-infected women and men.<h4>Design</h4>A French prospective cohort of HIV-infected patients of both sexes and all transmission categories.<h4>Methods</h4>We used hospital admission data from January 2000 to December 2008. A severe morbid event (SME) was defined as a clinical event requiring hospitalization for ≥48 h, several events could be reported during hospitalization. Yearly incidence rates of SME were estimated and compared using Generalized Estimating Equations.<h4>Results</h4>Among 4,987 patients (27% women), followed for a median of 8.7 years, 1,473 (30%) were hospitalized (3,049 hospitalizations for 5,963 SME). The yearly incidence rate of hospitalization decreased in men, from 155 in 2000 to 80/1,000 person-years (PY) in 2008 and in women, from 125 to 71/1,000 PY, (p<0.001). This trend was observed for all SME except for hepatic events, stable in men (15 to 13/1,000 PY) and increasing in women (2.5 to 11.5), cardiovascular events increasing in men (6 to 10/1,000 PY) and in women (6 to 14) and non-AIDS non-hepatic malignancies increasing in men (4 to 7/1,000 PY) and stable in women (2.5). Intraveneous drug users, age >50 years, HIV RNA >10,000 copies, CD4 <500/mm3, AIDS stage, hepatitis C co-infection and cardiovascular risk factors (diabetes, high blood pressure, and tobacco use) were associated with SME.<h4>Conclusions</h4>HIV-infected individuals in care in France require less and less frequently hospitalization. Women are now presenting with severe hepatic and cardio-vascular events. Disparities in SME between men and women are primarily explained by different exposure patterns to risk factors. Women should be targeted to benefit cardiovascular prevention policies as well as men.Mojgan HessamfarCéline ColinMathias BruyandMadeleine DecoinFabrice BonnetPatrick MerciéDidier NeauCharles CazanaveJean-Luc PellegrinFrançois DabisPhilippe MorlatGeneviève ChêneGECSA study groupPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e102671 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Mojgan Hessamfar
Céline Colin
Mathias Bruyand
Madeleine Decoin
Fabrice Bonnet
Patrick Mercié
Didier Neau
Charles Cazanave
Jean-Luc Pellegrin
François Dabis
Philippe Morlat
Geneviève Chêne
GECSA study group
Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.
description <h4>Objective</h4>To describe trends and determinants of severe morbidity in HIV-infected women and men.<h4>Design</h4>A French prospective cohort of HIV-infected patients of both sexes and all transmission categories.<h4>Methods</h4>We used hospital admission data from January 2000 to December 2008. A severe morbid event (SME) was defined as a clinical event requiring hospitalization for ≥48 h, several events could be reported during hospitalization. Yearly incidence rates of SME were estimated and compared using Generalized Estimating Equations.<h4>Results</h4>Among 4,987 patients (27% women), followed for a median of 8.7 years, 1,473 (30%) were hospitalized (3,049 hospitalizations for 5,963 SME). The yearly incidence rate of hospitalization decreased in men, from 155 in 2000 to 80/1,000 person-years (PY) in 2008 and in women, from 125 to 71/1,000 PY, (p<0.001). This trend was observed for all SME except for hepatic events, stable in men (15 to 13/1,000 PY) and increasing in women (2.5 to 11.5), cardiovascular events increasing in men (6 to 10/1,000 PY) and in women (6 to 14) and non-AIDS non-hepatic malignancies increasing in men (4 to 7/1,000 PY) and stable in women (2.5). Intraveneous drug users, age >50 years, HIV RNA >10,000 copies, CD4 <500/mm3, AIDS stage, hepatitis C co-infection and cardiovascular risk factors (diabetes, high blood pressure, and tobacco use) were associated with SME.<h4>Conclusions</h4>HIV-infected individuals in care in France require less and less frequently hospitalization. Women are now presenting with severe hepatic and cardio-vascular events. Disparities in SME between men and women are primarily explained by different exposure patterns to risk factors. Women should be targeted to benefit cardiovascular prevention policies as well as men.
format article
author Mojgan Hessamfar
Céline Colin
Mathias Bruyand
Madeleine Decoin
Fabrice Bonnet
Patrick Mercié
Didier Neau
Charles Cazanave
Jean-Luc Pellegrin
François Dabis
Philippe Morlat
Geneviève Chêne
GECSA study group
author_facet Mojgan Hessamfar
Céline Colin
Mathias Bruyand
Madeleine Decoin
Fabrice Bonnet
Patrick Mercié
Didier Neau
Charles Cazanave
Jean-Luc Pellegrin
François Dabis
Philippe Morlat
Geneviève Chêne
GECSA study group
author_sort Mojgan Hessamfar
title Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.
title_short Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.
title_full Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.
title_fullStr Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.
title_full_unstemmed Severe morbidity according to sex in the era of combined antiretroviral therapy: the ANRS CO3 Aquitaine Cohort.
title_sort severe morbidity according to sex in the era of combined antiretroviral therapy: the anrs co3 aquitaine cohort.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/0090efcae14d4428a236286fcfc70b8a
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