HIV and Hepatitis.com Coverage of the 15th
Conference on Retroviruses and Opportunistic Infections (CROI 2008) February
3 - 6, 2008, Boston, MA
The
material posted on HIV and Hepatitis.com about CROI 2008 is not approved by
nor is it a part of CROI 2008.
AIDS-related
Deaths in France Are More Frequent in Women than in Men since 2000
While
numerous studies have looked at the changing causes of mortality in people with
HIV/AIDS, few have focused on HIV
positive women.
As reported at the 15th Conference
on Retroviruses and Opportunistic Infections (CROI 2008) last week in Boston,
French researchers conducted a retrospective sub-study of the Mortalité
2000 and 2005 surveys to determine characteristics at the time of death in women
compared to men with HIV/AIDS.
All deaths occurring in HIV-infected adults
were reported through years 2000 and 2005 in national surveys. A standardized
questionnaire collected social, demographic, clinical, biological, and therapeutic
characteristics.
Results
•
Of the 1013 HIV-infected adults who died in
2005, 247 (24%) were women, compared with 22% of deaths in 2000.
•
32% of HIV positive women who died were infected
through injection drug use (vs 30% of men) and 53% were infected through heterosexual
intercourse (vs 25% of men).
•
In 2005, the proportion of AIDS-related diseases
was higher in women than in men (43% vs 34%; P = 0.01), whereas it did not differ
in 2000 (47% for both sexes).
•
In women, the age at death was lower than
that of men (43 vs 46 years; P < 0.001).
•
More women than men were of sub-Saharan African
origin (27% vs 9%; P < 0.001).
•
Socioeconomic "precariousness" was
also more common among the HIV positive women compared with men (38% vs 28%; P
= 0.006).
•
Conversely, rates of tobacco use (47% vs 59%;
P = 0.002) and excessive alcohol consumption (22% vs 31%; P = 0.008) were higher
in men than women.
•
Men also had a higher rate of dyslipidemia
(4% vs 10%; P = 0.01).
•
Although not statistically significant, women
who died seemed to be less likely to have used combination antiretroviral therapy
(77% vs 82%) and to have a lower CD4 count (137 vs 167 cells/mm3).
•
The 3 AIDS-related causes of death that were
more frequent in 2005 were non-Hodgkin's lymphoma (19% vs 21% in 2000), progressive
multifocal leukoencephalopathy (18% vs 3%), and cerebral toxoplasmosis (14% vs
17%).
•
Regarding non-AIDS-related causes of death
in 2005, women died less often than men from respiratory malignancies (lung, ear/nose/throat),
cardiovascular diseases (9% of all causes of death vs 16%; P = 0.004), and suicides
or accidents (4% vs 9%; P = 0.02).
•
Breast cancer was a cause of death in 3% and
cervical cancer in 2% of the women.
Conclusion
In
conclusion, the investigators noted that, in the context of a global decrease
since 2000, "AIDS-related deaths are nowadays more frequent in women than
in men."
"Even in a setting of universal access to care, HIV
positive women, especially migrants in poor socioeconomic conditions, may not
benefit from optimal case management," they added.
Finally, they concluded,
"Conversely, the lower proportion of non-AIDS causes of deaths observed in
women may be explained by a lower prevalence of traditional risk factors of respiratory
or cardiovascular diseases and of violent deaths."
Reference M
Hessamfar-Bonarek, G Chene, D Salmon, and others. (for the Mortalité 2000
& 2005 Study Group). Causes of Death in HIV-infected Women and Their Evolution
Since 2000: The Mortalité 2000 and 2005 Surveys, ANRS EN19. 15th Conference
on Retroviruses and Opportunistic Infections. Boston, MA. February 3-6, 2008.
Abstract 666.
AIDS-related
Deaths in France Are More Frequent in Women than in Men since 2000
While
numerous studies have looked at the changing causes of mortality in people with
Results
