Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010.
Buchacz, Kate; Lau, Bryan; Jing, Yuezhou; Bosch, Ronald; Abraham, Alison G.; Gill, M. John; Silverberg, Michael J.; Goedert, James J.; Sterling, Timothy R.; Althoff, Keri N.; Martin, Jeffrey N.; Burkholder, Greer; Gandhi, Neel; Samji, Hasina; Patel, Pragna; Rachlis, Anita; Thorne, Jennifer E.; Napravnik, Sonia; Henry, Keith; Mayor, Angel; Gebo, Kelly; Gange, Stephen J.; Moore, Richard D.; Brooks, John T.; for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA; Kirk, Gregory D.; Benson, Constance A.; Bosch, Ronald J.; Boswell, Stephen; Mayer, Kenneth H.; Grasso, Chris; Hogg, Robert S.; Harrigan, P. Richard; Montaner, Julio S.G.; Cescon, Angela; Samji, Hasina; Brooks, John T.; Buchacz, Kate; Gebo, Kelly A.; Moore, Richard D.; Moore, Richard D.; Carey, John T.; Rodriguez, Benigno; Horberg, Michael A.; Silverberg, Michael J.; Thorne, Jennifer E.; Goedert, James J.; Jacobson, Lisa P.; D'Souza, Gypsyamber; Klein, Marina B.; Rourke, Sean B.; Burchell, Ann N.; Rachlis, Anita R.; Hunter-Mellado, Robert F.; Mayor, Angel M.; Gill, M. John; Deeks, Steven G.; Martin, Jeffrey N.; Patel, Pragna; Brooks, John T.; Saag, Michael S.; Mugavero, Michael J.; Willig, James; Eron, Joseph J.; Napravnik, Sonia; Kitahata, Mari M.; Crane, Heidi M.; Drozd, Daniel R.; Sterling, Timothy R.; Rebeiro, Peter F.; Haas, David; Bebawy, Sally; Turner, Megan; Justice, Amy C.; Dubrow, Robert; Fiellin, David; Gange, Stephen J.; Anastos, Kathryn
[Article]
Journal of Infectious Diseases.
214(6):862-872, September 15, 2016.
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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.
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