Mortality by causes in HIV-infected adults: comparison with the general population

<p>Abstract</p> <p>Background</p> <p>We compared mortality by cause of death in HIV-infected adults in the era of combined antiretroviral therapy with mortality in the general population in the same age and sex groups.</p> <p>Methods</p> <p>Mortality by cause of death was analyzed for the period 1999-2006 in the cohort of persons aged 20-59 years diagnosed with HIV infection and residing in Navarre (Spain). This was compared with mortality from the same causes in the general population of the same age and sex using standardized mortality ratios (SMR).</p> <p>Results</p> <p>There were 210 deaths among 1145 persons diagnosed with HIV (29.5 per 1000 person-years). About 50% of these deaths were from AIDS. Persons diagnosed with HIV infection had exceeded all-cause mortality (SMR 14.0, 95% CI 12.2 to 16.1) and non-AIDS mortality (SMR 6.9, 5.7 to 8.5). The analysis showed excess mortality from hepatic disease (SMR 69.0, 48.1 to 78.6), drug overdose or addiction (SMR 46.0, 29.2 to 69.0), suicide (SMR 9.6, 3.8 to 19.7), cancer (SMR 3.2, 1.8 to 5.1) and cardiovascular disease (SMR 3.1, 1.3 to 6.1). Mortality in HIV-infected intravenous drug users did not change significantly between the periods 1999-2002 and 2003-2006, but it declined by 56% in non-injecting drug users (<it>P </it>= 0.007).</p> <p>Conclusions</p> <p>Persons with HIV infection continue to have considerable excess mortality despite the availability of effective antiretroviral treatments. However, excess mortality in the HIV patients has declined since these treatments were introduced, especially in persons without a history of intravenous drug use.</p

Caracterización de la pandemia de gripe A H1N1 2009 en Navarra

Fundamento. Describir la actividad gripal durante la pandemia de 2009-2010 en Navarra y compararla con la de temporadas anteriores. Métodos. Se han analizado los casos de gripe notificados en atención primaria y todas las confirmaciones virológicas realizadas en pacientes de atención primaria y en hospitales de Navarra entre las semanas 21 de 2009 y 20 de 2010. Resultados. El virus de la gripe A (H1N1) 2009 se detectó en Navarra entre las semana 23 de 2009 a la 2 de 2010, periodo en el que se registraron 39 casos con diagnóstico médico de síndrome gripal por 1.000 habitantes. El umbral epidémico se superó en dos periodos, con un pico en julio y otro mayor en noviembre. La mayor incidencia se alcanzó en niños de 5 a 14 años (121 por mil), seguidos por el grupo de menores de 5 años. Se produjeron 224 hospitalizaciones (36 por 100.000 habitantes) con confirmación de gripe A H1N1 2009, 8% de ellos requirieron ingreso en unidades de cuidados intensivos y hubo cuatro defunciones (0,6 por 100.000 habitantes). La tasa de hospitalizaciones fue mayor en niños menores de 5 años (163 por 100.000 habitantes), mientras que la probabilidad de derivación a cuidados intensivos aumentó con la edad. Conclusión. A pesar de no haber dispuesto de una vacuna específica hasta que la temporada estaba muy avanzada, el virus de gripe A (H1N1) 2009 produjo una onda gripal en rangos similares a los de otras temporadas y su repercusión en hospitalizaciones y casos graves fue moderada.Background. To describe influenza activity during the 2009-2010 pandemic in Navarre and compare it to previous seasons. Methods. An analysis was made of all influenza-like illness cases reported in primary care and all the virological confirmations made in patients in primary care and in hospitals of Navarre between week 21 of 2009 and week 20 of 2010. Results. Influenza 2009 H1N1 virus was detected in Navarre between week 23 of 2009 and week 2 of 2010, a period when 39 medically diagnosed cases of influenza-like illness per 1,000 inhabitants were registered. The epidemic threshold was surpassed in two periods, with a peak in July and a greater one in November. The greatest incidence was reached in children aged between 5 and 14 years (121 per thousand), followed by the group of under fives. There were 224 hospitalisations (36 per 100,000 inhabitants) with confirmation of influenza 2009 H1N1 virus, 8% of whom required admission to intensive care units and there were four deaths (0.6 per 100,000 inhabitants). The rate of hospitalisation was greater amongst children under five (163 per 100,000 inhabitants), while the probability of referral to intensive care increased with age. Conclusion. In spite of not having a specific vaccine available until the season was very well advanced, influenza 2009 H1N1 virus produced a wave of cases with similar incidence to those of other seasons and its repercussion in hospitalisations and serious cases was moderate

Caracterización de la pandemia de gripe A H1N1 2009 en Navarra

Fundamento. Describir la actividad gripal durante la pandemia de 2009-2010 en Navarra y compararla con la de temporadas anteriores. Métodos. Se han analizado los casos de gripe notificados en atención primaria y todas las confirmaciones virológicas realizadas en pacientes de atención primaria y en hospitales de Navarra entre las semanas 21 de 2009 y 20 de 2010. Resultados. El virus de la gripe A (H1N1) 2009 se detectó en Navarra entre las semana 23 de 2009 a la 2 de 2010, periodo en el que se registraron 39 casos con diagnóstico médico de síndrome gripal por 1.000 habitantes. El umbral epidémico se superó en dos periodos, con un pico en julio y otro mayor en noviembre. La mayor incidencia se alcanzó en niños de 5 a 14 años (121 por mil), seguidos por el grupo de menores de 5 años. Se produjeron 224 hospitalizaciones (36 por 100.000 habitantes) con confirmación de gripe A H1N1 2009, 8% de ellos requirieron ingreso en unidades de cuidados intensivos y hubo cuatro defunciones (0,6 por 100.000 habitantes). La tasa de hospitalizaciones fue mayor en niños menores de 5 años (163 por 100.000 habitantes), mientras que la probabilidad de derivación a cuidados intensivos aumentó con la edad. Conclusión. A pesar de no haber dispuesto de una vacuna específica hasta que la temporada estaba muy avanzada, el virus de gripe A (H1N1) 2009 produjo una onda gripal en rangos similares a los de otras temporadas y su repercusión en hospitalizaciones y casos graves fue moderada.Background. To describe influenza activity during the 2009-2010 pandemic in Navarre and compare it to previous seasons. Methods. An analysis was made of all influenza-like illness cases reported in primary care and all the virological confirmations made in patients in primary care and in hospitals of Navarre between week 21 of 2009 and week 20 of 2010. Results. Influenza 2009 H1N1 virus was detected in Navarre between week 23 of 2009 and week 2 of 2010, a period when 39 medically diagnosed cases of influenza-like illness per 1,000 inhabitants were registered. The epidemic threshold was surpassed in two periods, with a peak in July and a greater one in November. The greatest incidence was reached in children aged between 5 and 14 years (121 per thousand), followed by the group of under fives. There were 224 hospitalisations (36 per 100,000 inhabitants) with confirmation of influenza 2009 H1N1 virus, 8% of whom required admission to intensive care units and there were four deaths (0.6 per 100,000 inhabitants). The rate of hospitalisation was greater amongst children under five (163 per 100,000 inhabitants), while the probability of referral to intensive care increased with age. Conclusion. In spite of not having a specific vaccine available until the season was very well advanced, influenza 2009 H1N1 virus produced a wave of cases with similar incidence to those of other seasons and its repercussion in hospitalisations and serious cases was moderate