Mortality for liver disease in patients with HIV infection: a cohort study.

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Mortality for liver disease in patients with HIV infection: a cohort study.

J Acquir Immune Defic Syndr. 2000 Jul 1;24(3):211-7. Unique Identifier : AIDSLINE MED/20429898
Puoti M; Spinetti A; Ghezzi A; Donato F; Zaltron S; Putzolu V; Quiros-Roldan E; Zanini B; Casari S; Carosi G; II Divisione di Malattie Infettive, Azienda Spedali Civili,; Brescia, Italy. puoti_brambilla@iol.it

Abstract: We undertook this study to assess the association between the various potential causes of liver disease in HIV-seropositive patients and mortality due to liver failure. Three hundred and eight in-hospital deaths were observed from 1987 to December 1995 in a prospectively followed cohort of 1894 HIV-seropositive patients. For each study subject, clinical data were evaluated to assess whether liver failure had substantially contributed to mortality. A case control study nested in the cohort was then performed, which compared demographic and clinical variables observed at enrollment and during follow-up between patients who died for liver disease as the main or concurrent cause of death (cases) and those who died as a result of illness related to AIDS or other causes (controls). Among 308 in-hospital deaths, liver failure was found the cause of death in 35 patients (12%); in 16 cases, it was the primary cause and in 19 cases it was concurrent. Multivariate analysis showed that in-hospital liver-disease-related mortality was independently associated with hepatitis B surface antigen reactivity (odds ratio [OR], 9; 95% confidence interval [CI], 3.8-21.7) and history of alcohol abuse (OR, 2.3; 95% CI, 1-5.2). Prevention and treatment of hepatitis B virus infection and alcohol intake are management priorities in HIV-seropositive patients.

Keywords: JOURNAL ARTICLE Acquired Immunodeficiency Syndrome/COMPLICATIONS/MORTALITY Adult Alcoholism/MORTALITY Antibodies, Viral/ANALYSIS Case-Control Studies Cohort Studies Comparative Study Confidence Intervals DNA, Viral/ANALYSIS Female Hepatitis B e Antigens/ANALYSIS Hepatitis B Surface Antigens/ANALYSIS Hepatitis B Virus/GENETICS/ISOLATION & PURIF Hepatitis Delta Virus/IMMUNOLOGY Hepatitis, Viral, Human/ETIOLOGY/MORTALITY Human HIV Infections/*COMPLICATIONS Liver Diseases/*COMPLICATIONS/IMMUNOLOGY/MORTALITY Liver Failure/COMPLICATIONS/MORTALITY Male Multivariate Analysis Risk Factors

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