People diagnosed late in the UK are six times more likely to die of AIDS
A twelve-year analysis of deaths in people with HIV in the United Kingdom has shown that people who are
diagnosed late are six times more likely to die of AIDS than other people with HIV, Ruth Smith
told the British HIV Association conference in Bournemouth yesterday. Three quarters of AIDS deaths can
be attributed to late diagnosis (i.e. with a CD4 cell count below 350
have analysed deaths recorded in the UK’s national HIV surveillance
systems, supplemented by the death certificate records of the Office of National
Statistics, for the years 1997 to 2008.
introduction of combination therapy, there has been a dramatic decline in deaths
of people with HIV. The crude mortality rate for people aged 15 to 59 fell from
21.8 per 1000 in 1997 to 8.2 per 1000 in 2008. Nonetheless over 500 people with
HIV die each year, and rates are around five times higher than in the general
twelve-year period, 49% of deaths were due to AIDS. This proportion has
fluctuated over the years, but is not in steady decline.
researchers then conducted a case-control analysis. Each case of a person dying
of AIDS was matched with four controls who continued with live with HIV and who
were matched for their date of diagnosis and age at diagnosis.
multivariate analysis, after controlling for confounding factors, individuals
diagnosed with a CD4 cell count below 350 cells/mm3 were six times more likely
than others to die of AIDS (odds ratio 6.1, 95% confidence interval 4.9-7.5).
researchers estimate that 74% of all AIDS deaths were attributable to late
diagnosis. Even among individuals infected in the UK, 66% of AIDS
deaths could be attributed to late diagnosis.
demographic terms and still in multivariate analysis, men were more likely than
women to die of AIDS (odds ratio 1.3). However men who have sex with men were
less likely to die than men and women infected through heterosexual contact,
whether they were probably infected in Africa (odds ratio 1.4), the
UK (odds ratio 1.5) or elsewhere
drug users had a much higher risk of death – using men who have sex with men as
the comparison group, the odds ratio was 3.0.
common causes of AIDS deaths were PCP, other AIDS-related pneumonias,
non-Hodgkin's lymphoma, TB and neuro-cerebral causes.
researchers say their findings point to the importance of earlier diagnosis and
treatment in order to prevent deaths of people with HIV.