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J Infect Dis. 2016 Sep 15;214(6):862-72. doi: 10.1093/infdis/jiw085. Epub 2016 Apr 18.

Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010.

Author information

1
Divisions of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
2
Johns Hopkins University, Baltimore, Maryland.
3
Harvard University, Boston, Massachusetts.
4
University of Calgary, Alberta, Canada.
5
Kaiser Permanente Northern California, Oakland.
6
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
7
Vanderbilt University Medical Center, Nashville, Tennessee.
8
University of California-San Francisco.
9
University of Alabama at Birmingham.
10
Emory University, Atlanta, Georgia.
11
Johns Hopkins University, Baltimore, Maryland British Columbia Centre for Excellence in HIV/AIDS, Vancouver.
12
University of Toronto, Ontario, Canada.
13
University of North Carolina at Chapel Hill.
14
Hennepin County Medical Center, Minneapolis, Minnesota.
15
Universidad Central del Caribe, Puerto Rico.

Abstract

BACKGROUND:

There are few recent data on the rates of AIDS-defining opportunistic infections (OIs) among human immunodeficiency virus (HIV)-infected patients in care in the United States and Canada.

METHODS:

We studied HIV-infected participants in 16 cohorts in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) during 2000-2010. After excluding 16 737 (21%) with any AIDS-defining clinical events documented before NA-ACCORD enrollment, we analyzed incident OIs among the remaining 63 541 persons, most of whom received antiretroviral therapy during the observation. We calculated incidence rates per 100 person-years of observation (hereafter, "person-years") with 95% confidence intervals (CIs) for the first occurrence of any OI and select individual OIs during 2000-2003, 2004-2007, and 2008-2010.

RESULTS:

A total of 63 541 persons contributed 261 573 person-years, of whom 5836 (9%) developed at least 1 OI. The incidence rate of any first OI decreased over the 3 observation periods, with 3.0 cases, 2.4 cases, and 1.5 cases per 100 person-years of observation during 2000-2003, 2004-2007, and 2008-2010, respectively (Ptrend<.001); the rates of most individual OIs decreased as well. During 2008-2010, the leading OIs included Pneumocystis jiroveci pneumonia, esophageal candidiasis, and disseminated Mycobacterium avium complex or Mycobacterium kansasii infection.

CONCLUSIONS:

For HIV-infected persons in care during 2000-2010, rates of first OI were relatively low and generally declined over this time.

KEYWORDS:

AIDS-related opportunistic infections; CD4+ T-lymphocyte count; HIV cohort studies; combination antiretroviral therapy; epidemiology; incidence; prophylaxis

PMID:
27559122
PMCID:
PMC4996145
DOI:
10.1093/infdis/jiw085
[Indexed for MEDLINE]
Free PMC Article

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