3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

RISK FACTORS FOR DECOMPENSATED CIRRHOSIS AND ASSOCIATED MORBIDITY AND MORTALITY IN I.CO.N.A.

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuPe1.1C24

Cicconi P.¹, Puoti M.², Cozzi Lepri A.³, Cosco L.⁴, Morsica G.⁵, Santantonio T.⁶, Ancarani F.⁷, Cargnel A.⁸, d'Arminio Monforte A.^1
1Clinic of Infectious Diseases University of Milan, Milan, Italy, ²Clinic of Infectious Diseases University of Brescia, Brescia, Italy, ³Royal Free Hospital, London, United Kingdom, ⁴Div. Infectious Diseases H.A.Puglise, Catanzaro, Italy, ⁵Clinic of Infectious Diseases Ateneo Vita e Salute, Milan, Italy, ⁶Inst. Infectious Diseases University of Bari, Bari, Italy, ⁷Inst. Infectious Diseases University of Ancona, Ancona, Italy, ⁸II Div. Infectious Diseases H.L.Sacco, Milan, Italy

INTRODUCTION: Goals of the study: to evaluate incidence and predictors of decompensated cirrhosis (DC) in I.Co.N.A. and to assess DC-related morbidity and mortality.

METHODS: 5138 non-DC patients were included. We used: a person-years analysis to evaluate DC-incidence; a Poisson regression for the multivariable model; two linear regression models to compare (a) proportion of time spent in hospital by patients with and without DC and (b) the average duration of hospitalisations for DC or not-DC; a Kaplan Meyer analysis to estimate the average survival after DC; a Cox model to investigate the association between DC and the death risk.

RESULTS: Incidence analysis: crude DC-incidence was 1.85/1000 person-years. The rate ratio adjusted for demographics, current therapy, HCV, HBV, baseline CD4 and current ALT didn't show significant changes over calendar year. IDU (RR=17.31, vs. heterosexuals, 95% CI: 3.46-86.52, p=0.0005) and older patients (RR=1.66 per 10 years older, 95% CI:0.98-2.81, p=0.06) showed an independent higher risk for DC. Different HAART regimens didn't influence DC-incidence. Hospitalisation and risk of death: DC-patients spent on average 10% (95% CI: 5%-15%, p=0.0001) higher proportion of time while hospitalised, but their hospitalizations resulted 2.7 days shorter (p=0.4). DC was independently associated with a higher risk of death (RR=8.5, 95% CI: 4.01-12.9, p<0.0001). Survival after DC: 19/36 DC-patients died after the DC diagnosis. Median survival from DC was 126 days (95% CI: 20-232). The probabilities of survival by 1 and 2 years after DC were 27% (95% CI:16.71-37.29%) and 10.8% (95% CI:3.59-18.1%).

CONCLUSIONS: DC incidence in I.Co.N.A. is constant over calendar year and is affected by IDU and age. HAART doesn't influence DC incidence. DC-patients spend more time in hospital but the length of each stay is comparable to non-cirrhotics. DC-patients have an 8.5-fold increase in the risk of death and their survival is very poor.

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050724
Clinical | TuPe1.1C24 | Paola Cicconi
Hepatitis viruses

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