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Causes of death in HIV-infected patients from the Cologne–Bonn cohort

  • Clinical and Epidemiological Study
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Abstract

Purpose

Causes of death in human immunodeficiency virus (HIV)-infected subjects have changed in countries with high resources over the last several years. Acquired immunodeficiency syndrome (AIDS)-related diseases have become less prevalent, whereas deaths due to non-AIDS causes are increasing. The aim of the present study was to analyse causes of death in the Cologne–Bonn cohort.

Methods

Causes of death from the Cologne–Bonn cohort between 2004 and 2010 were systematically recorded using the CoDe algorithm (The Coding Causes of Death in HIV Project).

Results

In 3,165 patients followed from 2004 to 2010, 182 deaths occurred (5.7 %, 153 males, 29 females). The median age at the time of death was 47 years (range 24–85 years). The most frequent causes of death were AIDS-defining events (n = 60, 33 %), with non-Hodgkin lymphoma (NHL) (n = 29, 16 %) and infections (n = 20, 11 %) being the leading entities in this category. Non-AIDS malignancies accounted for 16 % (n = 29), non-HIV-related infections for 10 % (n = 18), cardiovascular diseases for 7 % (n = 14), suicide or accident for 4 % (n = 7) and liver diseases for 3 % (n = 5) of deaths (unknown n = 47, 26 %). Although the majority of patients (92.5 %) was on antiretroviral therapy (ART), only 50 % were virologically suppressed (HIV-RNA <50 copies/mL) and 44 % had a decreased CD4+ count (<200/μL) at their last visit before death.

Conclusion

One-third of the causes of death in our cohort between 2004 and 2010 was AIDS-related. Since most of these deaths occur with severe immune suppression, they can possibly be prevented by the early diagnosis and treatment of HIV infection. Care providers must be aware of an increased risk for a broad range of diseases in HIV-infected patients and should apply appropriate preventive measures.

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Conflict of interest

The Cologne–Bonn cohort is supported by the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF).

JJV, NJ, CL and CW are supported by grant 01KI 0771 from the German Federal Ministry of Education and Research (Bundesministerium für Bildung und Forschung, BMBF).

GF has received research grants from the German Federal Ministry of Education and Research (BMBF) 01KI1017 and 01KG0915, and has received lecture fees, travel grants or is an advisor to Abbott, Bristol Myers Squibb, Gilead, Janssen-Cilag, Merck Sharp & Dohme and Pfizer.

OAC is supported by the German Federal Ministry of Research and Education (BMBF grant 01KN1106) and has received research grants from, is an advisor to or received lecture honoraria from 3M, Actelion, Astellas, Basilea, Bayer, Celgene, Cubist, F2G, Genzyme, Gilead, GSK, Merck/MSD, Miltenyi, Optimer, Pfizer, Quintiles, Sanofi Pasteur and Viropharma.

JKR has received honoraria for consulting or speaking at educational events from AbbVie, Bionor, BMS, Boehringer Ingelheim, Gilead, Janssen, Merck, Roche and ViiV Healthcare.

CB has received honoraria for consulting or educational lectures from Abbott, AbbVie, BMS, Boehringer, Gilead, Janssen, Merck and Roche.

KE has received honoraria for educational lectures from Abbott.

JCW has received consulting honoraria and travel grants from Abbott/AbbVie, Bristol-Myers Squibb, Gilead Sciences, Janssen Pharmaceutical and ViiV Healthcare.

CW has received consulting fees from Boehringer Ingelheim, fees for speaking engagements from Bristol-Myers Squibb, Gilead Sciences, ViiV Healthcare, MSD, Janssen-Cilag, Essex, Pfizer and Abbott.

NJ has received honoraria for lectures or travel grants from Abbott, bioMérieux, BMX, Essex, Gilead, GSK, Labor Stein, MSD, Novartis, Pfizer and Roche.

Ethical standards statement

The study was approved by the Ethical Committee of the Medical Faculty of the University of Cologne and written informed consent was obtained from the patients.

Author information

Authors and Affiliations

  1. First Department of Internal Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany

    K. Ehren, C. Hertenstein, T. Kümmerle, J. J. Vehreschild, J. Fischer, D. Gillor, C. Wyen, C. Lehmann, O. A. Cornely, N. Jung, S. Gravemann, M. Platten & G. Fätkenheuer

  2. Clinical Trials Centre Cologne, ZKS Köln, BMBF 01KN1106, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany

    O. A. Cornely

  3. Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany

    J. C. Wasmuth, J. K. Rockstroh, C. Boesecke & C. Schwarze-Zander

  4. German Centre for Infection Research (DZIF), partner site Bonn–Cologne, Braunschweig, Germany

    J. J. Vehreschild, J. Fischer, O. A. Cornely, S. Gravemann, M. Platten, J. K. Rockstroh & G. Fätkenheuer

Authors
  1. K. Ehren
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  2. C. Hertenstein
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  3. T. Kümmerle
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  4. J. J. Vehreschild
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  5. J. Fischer
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  6. D. Gillor
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  7. C. Wyen
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  8. C. Lehmann
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  9. O. A. Cornely
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  10. N. Jung
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  11. S. Gravemann
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  12. M. Platten
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  13. J. C. Wasmuth
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  14. J. K. Rockstroh
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  15. C. Boesecke
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  16. C. Schwarze-Zander
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  17. G. Fätkenheuer
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Corresponding author

Correspondence to K. Ehren.

Additional information

K. Ehren and C. Hertenstein contributed equally to this manuscript.

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Ehren, K., Hertenstein, C., Kümmerle, T. et al. Causes of death in HIV-infected patients from the Cologne–Bonn cohort. Infection 42, 135–140 (2014). https://doi.org/10.1007/s15010-013-0535-7

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  • DOI: https://doi.org/10.1007/s15010-013-0535-7

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