Time trends in causes of death in people with human immunodeficiency virus: Insights from the Swiss HIV Cohort Study. Clinical Infectious Diseases
In their January 2024 article published in Clinical Infectious Diseases, Weber et al. analyzed the evolving causes of death among people living with HIV in the Swiss HIV Cohort Study over the past 17 years.
The authors of the study formed a narrative of the events leading to each reported death between 2005 and 2022, leveraging all available information from the cohort’s comprehensive data source. The study included 1630 deaths, of which 23.7% occurred in women. The demographic profile at the time of death showed significant shifts: The median age at death rose from 45 years in 2005-2007 to 61 years in 2020-2022, and the proportion of people who inject drugs decreased from 46.4% to 22.5% of the deaths reported over the same period.
Over the study period, there was a notable decline in HIV/AIDS-related deaths, dropping from 18.5% of total deaths in 2005-2007 to just 3.7% in 2020-2022. Similarly, liver-related deaths decreased significantly from 15.2% to 2.2% during the same timeframe. These declines underscore the efficacy of antiretroviral therapy and advancements in managing hepatitis C coinfection. Cardiovascular-related deaths remained stable over time, accounting for approximately 11% of total deaths throughout the study period. Conversely, non-AIDS and non-hepatic (NANH) cancers have emerged as a growing concern, increasing from 14.9% of deaths in 2005-2007 to 31.1% of deaths in 2020-2022, with lung cancer being the predominant cause in this category.
In conclusion, the findings underscore the success of current HIV treatment and care, along with effective interventions targeting HCV coinfection, which have significantly reduced HIV/AIDS and liver-related mortality in recent decades. Future efforts should focus on prevention, early detection and enhanced treatments for NANH cancers and cardiovascular conditions.