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PreAIDS mortality in HIVinfected individuals in England, Wales and Northern Ireland, 19821996

Laurichesse, Henri A.A.1; Mortimer, Janet1; Evans, Barry G.1,3; Farrington, C Paddy2

Article

Objective: To assess pre-AIDS mortality in HIV-infected patients in England, Wales and Northern Ireland during the period 1982–1996.

Design: Surveillance data on pre-AIDS and AIDS deaths reported to the PHLS-AIDS Centre were analysed.

Methods: Pre-AIDS mortality was estimated as the proportion of pre-AIDS deaths among all deaths in HIV-infected people. Trends over time in the number of pre-AIDS and AIDS deaths were compared using Poisson regression with logarithmic link. Causes of pre-AIDS deaths were recorded. Comparisons were made between the pre-AIDS and the AIDS death groups by logistic regression for: age, location of residence at death, year of death and risk exposure.

Results: Four-hundred and sixty-eight pre-AIDS deaths and 8574 AIDS deaths were identified. Pre-AIDS mortality accounted for 5.0% of HIV-related deaths. Trends over time in the number of pre-AIDS and AIDS deaths were not significantly different (P = 0.11). Reported causes of pre-AIDS death included pneumonia (92), liver disease (62), septicaemia (51), malignancies (49), suicide (45), cardiopulmonary causes (46), haemorrhage (42), overdose (24) and accidental causes (24). Factors positively associated with pre-AIDS death were injecting drug use, haemophilia and blood transfusion, residence outside the Thames regions, and death at an older age.

Conclusions: Pre-AIDS mortality represents a substantial proportion of HIV mortality, particularly where injecting drug use is a frequent route of HIV transmission.

1Public Health Laboratory Service AIDS and Sexually Transmitted Diseases Centre

2Public Health Statistics Unit, Communicable Disease Surveillance Centre, London, UK.

3Requests for reprints to: Barry G. Evans, Public Health Laboratory Service AIDS and Sexually Transmitted Diseases Centre, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK.

Date of receipt: 9 May 1997; revised 17 December 1997; accepted 7 January 1998.

© Lippincott-Raven Publishers.