172445 Trends in Diseases Reported on Death Certificates that Mentioned HIV Infection, USA, 1996 - 2005

Wednesday, October 29, 2008: 12:35 PM

William K. Adih, MD, MPH, DrPH , Centers for Disease Control and Prevention, HIV Incidence and Case Surveillance Branch, Atlanta, GA
Richard M. Selik, MD , Centers for Disease Control and Prevention, HIV Incidence and Case Surveillance Branch, Atlanta, GA
Background: Widespread use of highly active antiretroviral therapy after 1995 reduced deaths among persons with HIV. We examined trends during 19962005 in diseases reported on death certificates that mentioned HIV infection.

Methods: We analyzed multiple-cause mortality data compiled by the National Center for Health Statistics from all US death certificates with any mention of HIV infection to determine the annual percentages of deaths with various diseases, standardized to the age, sex, and racial distribution of the US population in 2000.

Results: Deaths reported with HIV infection decreased from 35,340 in 1996 to 14,376 in 2005. Standardized percentages of death certificates reporting AIDS-defining opportunistic infections also decreased: pneumocytosis (6.3% to 5.3%), non-tuberculous mycobacteriosis (5.5% to 1.8%), cytomegalovirus (5.7% to 1.0%). For AIDS-defining cancers, Non-Hodgkin's lymphoma rose from 4.8% in 1996 to 6.4% in 1997 and declined to 5.0% in 2005, while Kaposi's sarcoma declined from 3.7% in 1996 to 1.7% in 2005. The percentage of deaths reported with diseases not specifically attributable to HIV increased from 1996 to 2005: non-AIDS defining cancers combined (2.7% to 7.7%), liver disease (5.8% to 13.3%), kidney disease (7.9% to 11.8%), heart disease (4.9% to 9.6%). The median age at death increased from 39 years to 46 years.

Conclusion: Deaths among persons with HIV decreased over 50% during the analysis period. The percentage of deaths reported with HIV-attributable diseases decreased, while the percentage reported with other diseases increased. Consequently, diseases not attributable to HIV may need increased attention in the clinical management of HIV-infected persons.

Learning Objectives:
At the conclusion of the session, the participant will be able to: Describe trends in diseases reported on US death certificates that mentioned HIV infection during 19962005. Identify the AIDS-defining diseases whose proportions have decreased during the period and other conditions not specifically attributable to HIV whose proportions have increased. Recognize the need for increased attention to other diseases not attributable to HIV infection.

Keywords: HIV/AIDS, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an MD, hold masters and doctoral degrees in public health, and an Epidemiologist with the HIV Incidence and Case Surveillance Branch, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: HIV/AIDS Epidemiology
See more of: Epidemiology