Trends in Mortality in People With HIV From 1999 through 2020: A Multicohort Collaboration
Authors: Tusch Erich , Ryom Lene , Pelchen-Matthews Annegret , Mocroft Amanda , Elbirt Daniel , Oprea Cristiana , Günthard Huldrych F , Staehelin Cornelia , Zangerle Robert , Suarez Isabelle , Vehreschild Jörg Janne , Wit Ferdinand , Menozzi Marianna , d'Arminio Monforte Antonella , Spagnuolo Vincenzo , Pradier Christian , Carlander Christina , Suanzes Paula , Wasmuth Jan-Christian , Carr Andrew , Petoumenos Kathy , Borgans Frauke , Bonnet Fabrice , De Wit Stephane , El-Sadr Wafaa , Neesgaard Bastian , Jaschinski Nadine , Greenberg Lauren , Hosein Sean R , Gallant Joel , Vannappagari Vani , Young Lital , Sabin Caroline , Lundgren Jens , Peters Lars , Reekie Joanne ,   D:A:D cohort study, El-Sadr W , Calvo G , Bonnet F , Dabis F , Kirk O , Mocroft A , Law M , d’Arminio Monforte A , Morfeldt L , Pradier C , Reiss P , Weber R , De Wit S , Lind-Thomsen A , Brandt R Salbøl , Hillebreght M , Zaheri S , Wit F W N M , Scherrer A , Schöni-Affolter F , Rickenbach M , Tavelli A , Fanti I , Leleux O , Mourali J , Marec F Le , Boerg E , Thulin E , Sundström A , Bartsch G , Thompsen G , Necsoi C , Delforge M , Fontas E , Caissotti C , Dollet K , Mateu S , Torres F , Petoumenos K , Blance A , Huang R , Puhr R , Laut K Grønborg , Kristensen D , Sabin C A , Phillips A N , Kamara D A , Smith C J , Mocroft A , Hatleberg C I , Lind-Thomsen A , Brandt R S , Raben D , Matthews C , Bojesen A , Grevsen A L , Lundgren J D , Ryom L , Powderly B , Shortman N , Moecklinghoff C , Reilly G , Franquet X , Ryom L , Mocroft A , Kirk O , Reiss P , Smit C , Ross M , Fux C A , Morlat P , Fontas E , Kamara D A , Smith C J , Lundgren J D , Smith C J , Ryom L , Hatleberg C I , Phillips A N , Weber R , Morlat P , Pradier C , Reiss P , Wit F W N M , Friis-Møller N , Kowalska J , Lundgren J D , Sabin C A , Ryom L , Hatleberg C I , Law M , d’Arminio Monforte A , Dabis F , Bonnet F , Reiss P , Wit F W N M , Smith C J , Kamara D A , Bohlius J , Bower M , Fätkenheuer G , Grulich A , Lundgren J D , Sjøl A , Meidahl P , Iversen J S , Reiss Central P , Zaheri S , Hillebregt M , Wit F W N M , Prins J M , Kuijpers T W , Scherpbier H J , van der Meer J T M , Wit F W N M , Godfried M H , Reiss P , van der Poll T , Nellen F J B , Geerlings S E , van Vugt M , Pajkrt D , Bos J C , Wiersinga W J , van der Valk M , Goorhuis A , Hovius J W , van Eden J , Henderiks A , van Hes A M H , Mutschelknauss M , Nobel H E , Pijnappel F J J , Jurriaans S , Back N K T , Zaaijer H L , Berkhout B , Cornelissen M T E , Schinkel C J , Thomas X V , De Ruyter Ziekenhuis Admiraal , van den Berge M , Stegeman A , Baas S , de Looff L Hage , Versteeg D , Ziekenhuis Catharina , Pronk M J H , Ammerlaan H S M , De Munnik E S , Jansz A R , Tjhie J , Wegdam M C A , Deiman B , Scharnhorst V , van der Plas A , Weijsenfeld A M , van der Ende M E , De Vries-Sluijs T E M S , van Gorp E C M , Schurink C A M , Nouwen J L , Verbon A , Rijnders B J A , Bax H I , van der Feltz M , Bassant N , van Beek J E A , Vriesde M , van Zonneveld L M , de Oude-Lubbers A , van den Berg-Cameron H J , Bruinsma-Broekman F B , de Groot J , de Man M de Zeeuw- , Boucher C A B , Koopmans M P G , van Kampen J J A , Pas S D , MC–Sophia Erasmus , Driessen G J A , van Rossum A M C , van der Knaap L C , Visser E , Branger J , Rijkeboer-Mes A , de Ven C J H M Duijf-van , Ziekenhuis Haga , Schippers E F , van Nieuwkoop C , van IJperen J M , Geilings J , van der Hut G , Franck P F H , van Eeden A , Brokking W , Groot M , Elsenburg L J M , Damen M , Kwa I S , Groeneveld P H P , Bouwhuis J W , van den Berg J F , van Hulzen A G W , van der Bliek G L , Bor P C J , Bloembergen P , Wolfhagen M J H M , Ruijs G J H M , Kroon F P , de Boer M G J , Bauer M P , Jolink H , Vollaard A M , Dorama W , van Holten N , Claas E C J , Wessels E , den Hollander J G , Pogany K , Roukens A , Kastelijns M , Smit J V , Smit E , Struik-Kalkman D , Tearno C , Bezemer M , van Niekerk T , Pontesilli O , Lowe S H , Lashof A M L Oude , Posthouwer D , Ackens R P , Schippers J , Vergoossen R , Weijenberg-Maes B , van Loo I H M , Havenith T R A , Leyten E M S , Gelinck L B S , van Hartingsveld A , Meerkerk C , Wildenbeest G S , Mutsaers J A E M , Jansen C L , Mulder J W , Vrouenraets S M E , Lauw F N , van Broekhuizen M C , Paap H , Vlasblom D J , Smits P H M , Zuiderzee M C , Weijer S , El Moussaoui R , Bosma A S , van Vonderen M G A , van Houte D P F , Kampschreur L M , Dijkstra K , Faber S , Weel J , Kootstra G J , Delsing C E , van der Burg-van de Plas M , Heins H , Lucas E , Kortmann W , van Twillert G , Stuart J W T Cohen , Diederen B M W , Pronk D , van Truijen-Oud F A , van der Reijden W A , Jansen R , Brinkman K , van den Berk G E L , Blok W L , Frissen P H J , Lettinga K D , Schouten W E M , Veenstra J , Brouwer C J , Geerders G F , Hoeksema K , Kleene M J , van der Meché I B , Spelbrink M , Sulman H , Toonen A J M , Wijnands S , Damen M , Kwa D , Witte E , Koopmans P P , Keuter M , van der Ven A J A M , ter Hofstede H J M , Dofferhoff A S M , van Crevel R , Albers M , Bosch M E W , Grintjes-Huisman K J T , Zomer B J , Stelma F F , Rahamat-Langendoen J , Burger D , Richter C , Gisolf E H , Hassing R J , ter Beest G , van Bentum P H M , Langebeek N , Tiemessen R , Swanink C M A , van Lelyveld S F L , Soetekouw R , Hulshoff N , van der Prijt L M M , van der Swaluw J , Bermon N , van der Reijden W A , Jansen R , Herpers B L , Veenendaal D , Verhagen D W M , van Wijk M , Ziekenhuis St Elisabeth , van Kasteren M E E , Brouwer A E , de Kruijf-van de Wiel B A F M , Kuipers M , Santegoets R M W J , van der Ven B , Marcelis J H , Buiting A G M , Kabel P J , Bierman W F W , Scholvinck H , Wilting K R , Stienstra Y , de Groot-de Jonge H , van der Meulen P A , de Weerd D A , Ludwig-Roukema J , Niesters H G M , Riezebos-Brilman A , van Leer-Buter C C , Knoester M , Hoepelman A I M , Mudrikova T , Ellerbroek P M , Oosterheert J J , Arends J E , Barth R E , Wassenberg M W M , Schadd E M , van Elst-Laurijssen D H M , van Oers-Hazelzet E E B , Vervoort S , van Berkel M , Schuurman R , Verduyn-Lunel F , Wensing A M J , Peters E J G , van Agtmael M A , Bomers M , de Vocht J , Heitmuller M , Laan L M , Pettersson A M , Vandenbroucke-Grauls C M J E , Ang C W , Kinderziekenhuis Wilhelmina , Geelen S P M , Wolfs T F W , Bont L J , Nauta N , Reiss P , Bezemer D O , van Sighem A I , Smit C , Wit F W N M , Boender T S , Zaheri S , Hillebregt M , de Jong A , Bergsma D , Hoekstra P , de Lang A , Grivell S , Jansen A , Rademaker M J , Raethke M , Meijering R , Schnörr S , de Groot L , van den Akker M , Bakker Y , Claessen E , El Berkaoui A , Koops J , Kruijne E , Lodewijk C , Munjishvili L , Peeck B , Ree C , Regtop R , Ruijs Y , Rutkens T , van de Sande L , Schoorl M , Timmerman A , Tuijn E , Veenenberg L , van der Vliet S , Wisse A , Woudstra T , Tuk B , Bonnet F , Dabis F , Dupon M , Gaborieau V , Lacoste D , Malvy D , Mercié P , Morlat P , Neau D , Pellegrin J L , Tchamgoué S , Lazaro E , Cazanave C , Vandenhende M , Vareil M O , Gérard Y , Blanco P , Bouchet S , Breilh D , Fleury H , Pellegrin I , Chêne G , Thiébaut R , Wittkop L , Wittkop L , Leleux O , Lawson-Ayayi S , Gimbert A , Desjardin S , Lacaze-Buzy L , Petrov-Sanchez V , Bonnet F , Chêne G , Dabis F , Thiébaut R , Wittkop L , André K , Bernard N , Bonnet F , Caubet O , Caunegre L , Cazanave C , Chossat I , Courtault C , Dauchy F A , De Witte S , Dondia D , Dupon M , Duffau P , Dutronc H , Farbos S , Faure I , Ferrand H , Gaborieau V , Gerard Y , Greib C , Hessamfar M , Imbert Y , Lacoste D , Lataste P , Lazaro E , Malvy D , Marie J , Mechain M , Mercié P , Monlun E , Morlat P , Neau D , Ochoa A , Pellegrin J L , Pistone T , Raymond I , Receveur M C , Rispal P , Sorin L , Tchamgoué S , Valette C , Vandenhende M A , Vareil M O , Viallard J F , Wille H , Wirth G , Pellegrin I , Blanco P , Fleury H , Lafon Me , Trimoulet P , Bellecave P , Tumiotto C , Bouchet S , Breilh D , Haramburu F , Miremeont-Salamé G , Blaizeau M J , Decoin M , Hannapier C , Lenaud E , Pougetoux A , Delveaux S , D’Ivernois C , Diarra F , Uwamaliya-Nziyumvira B , Leleux O , Marec F Le , Boerg Eloïse , Lawson-Ayayi S , Palmer G , Conte V , Sapparrart V , Law Central M , Petoumenos K , Puhr R , Huang R , Moore R , Edwards S , Hoy J , Watson K , Roth N , Lau H , Bloch M , Baker D , Carr A , Cooper D , O’Sullivan M , Nolan D , Guelfi G , Calvo Central G , Torres F , Mateu S , Domingo P , Sambeat M A , Gatell J , Del Cacho E , Cadafalch J , Fuster M , Codina C , Sirera G , Vaqué A , De Wit S , Clumeck N , Delforge M , Necsoi C , Clumeck N , De Wit S , Gennotte A F , Gerard M , Kabeya K , Konopnicki D , Libois A , Martin C , Payen M C , Semaille P , Van Laethem Y , De Wit S , Clumeck N , Delforge M , Necsoi C , Clumeck N , De Wit S , Gennotte A F , Gerard M , Kabeya K , Konopnicki D , Libois A , Martin C , Payen M C , Semaille P , Van Laethem Y , Neaton Central J , Bartsch G , El-Sadr W M , Krum E , Thompson G , Wentworth D , Luskin-Hawk R , Telzak E , El-Sadr W M , Abrams D I , Cohn D , Markowitz N , Arduino R , Mushatt D , Friedland G , Perez G , Tedaldi E , Fisher E , Gordin F , Crane L R , Sampson J , Baxter J , Gatell J , Gazzard B , Horban A , Karpov I , Losso M , d’Arminio Monforte A , Pedersen C , Ristola M , Phillips A , Reiss P , Lundgren J , Rockstroh J , Rockstroh J , Mocroft A , Kirk O , Kirk O , Peters L , Matthews C , Fischer A H , Bojesen A , Raben D , Kristensen D , Laut K Grønborg , Larsen J F , Podlekareva D , Mocroft A , Phillips A , Cozzi-Lepri A , Shepherd L , Schultze A , Amele S , Losso M , Kundro M , Schmied B , Wien Pulmologisches Zentrum der Stadt , Zangerle R , Karpov I , Vassilenko A , Mitsura V M , Paduto D , Clumeck N , De Wit S , Delforge M , Florence E , Vandekerckhove L , Hadziosmanovic V , Begovac J , Machala L , Jilich D , Sedlacek D , Kronborg G , Benfield T , Gerstoft J , Katzenstein T , Møller N F , Pedersen C , Ostergaard L , Wiese L , Nielsen L N , Zilmer K , Smidt Jelena , Siseklinik Nakkusosakond , Ristola M , Aho I , Viard J-P , Pradier C , Fontas E , Duvivier C , Rockstroh J , Schmidt R , Degen O , Stellbrink H J , Stefan C , Goethe J W , Bogner J , Fätkenheuer G , Chkhartishvili N , Gargalianos P , Xylomenos G , Armenis K , Sambatakou H , Szlávik J , Gottfredsson M , Mulcahy F , Yust I , Turner D , Burke M , Shahar E , Hassoun G , Elinav H , Haouzi M , Elbirt D , Sthoeger Z M , D’Arminio Monforte A , Esposito R , Mazeu I , Mussini C , Mazzotta F , Gabbuti A , Annunziata Ospedale S Maria , Vullo V , Lichtner M , Zaccarelli M , Antinori A , Acinapura R , Plazzi M , Lazzarin A , Castagna A , Gianotti N , Galli M , Ridolfo A , Rozentale B , Uzdaviniene V , Matulionyte R , Staub T , Hemmer R , Reiss P , Ormaasen V , Maeland A , Bruun J , Knysz B , Gasiorowski J , Inglot M , Horban A , Bakowska E , Flisiak R , Grzeszczuk A , Parczewski M , Maciejewska K , Aksak-Was B , Beniowski M , Mularska E , Smiatacz T , Gensing M , Jablonowska E , Malolepsza E , Wojcik K , Mozer-Lisewska I , Caldeira L , Mansinho K , Maltez F , Radoi R , Oprea C , Panteleev A , Panteleev O , Yakovlev A , Trofimora T , Khromova I , Kuzovatova E , Blokhina I N , Novogrod Nizhny , Borodulina E , Vdoushkina E , Jevtovic D , Tomazic J , Gatell J M , Miró J M , Moreno S , Rodriguez J M , Clotet B , Jou A , Paredes R , Tural C , Puig J , Bravo I , Domingo P , Gutierrez M , Mateo G , Sambeat M A , Laporte J M , Carlander C , Sonnerborg A , Brännström I , Flamholc L , Scherrer A , Weber R , Cavassini M , Calmy A , Furrer H , Battegay M , Schmid P , Kuznetsova A , Kyselyova G , Sluzhynska M , Gazzard B , Johnson A M , Simons E , Edwards S , Phillips A , Johnson M A , Mocroft A , Orkin C , Weber J , Scullard G , Clarke A , Leen C , Morfeldt Central L , Thulin G , Sundström A , Åkerlund B , Koppel K , Karlsson A , Flamholc L , Håkangård C , d’Arminio Monforte A , Antinori A , Castagna A , Castelli F , Cauda R , Perri G Di , Galli M , Iardino R , Ippolito G , Marchetti G C , Perno C F , von Schloesser F , Viale P , d’Arminio Monforte A , Antinori A , Castagna A , Ceccherini-Silberstein F , Cozzi-Lepri A , Girardi E , Caputo S Lo , Mussini C , Puoti M , Andreoni M , Ammassari A , Antinori A , Balotta C , Bandera A , Bonfanti P , Bonora S , Borderi M , Calcagno A , Calza L , Capobianchi M R , Castagna A , Ceccherini-Silberstein F , Cingolani A , Cinque P , Cozzi-Lepri A , d’Arminio Monforte A , De Luca A , Biagio A Di , Girardi E , Gianotti N , Gori A , Guaraldi G , Lapadula G , Lichtner M , Caputo S Lo , Madeddu G , Maggiolo F , Marchetti G , Marcotullio S , Monno L , Mussini C , Nozza S , Puoti M , Roldan E Quiros , Rossotti R , Rusconi S , Santoro M M , Saracino A , Zaccarelli M , Cozzi-Lepri A , Fanti I , Galli L , Lorenzini P , Rodano A , Shanyinde M , Tavelli A , Carletti F , Carrara S , Caro A Di , Graziano S , Petrone F , Prota G , Quartu S , Truffa S , Giacometti A , Costantini A , Barocci V , Angarano G , Monno L , Santoro C , Maggiolo F , Suardi C , Viale P , Donati V , Verucchi G , Castelli F , Minardi C , Roldan E Quiros , Quirino T , Abeli C , Manconi P E , Piano P , Cacopardo B , Celesia B , Vecchiet J , Falasca K , Pan A , Lorenzotti S , Sighinolfi L , Segala D , Mazzotta F , Vichi F , Cassola G , Viscoli C , Alessandrini A , Bobbio N , Mazzarello G , Mastroianni C , Belvisi V , Bonfanti P , Caramma I , Chiodera A , Milini P , d’Arminio Monforte A , Galli M , Lazzarin A , Rizzardini G , Puoti M , Castagna A , Marchetti G , Moioli M C , Piolini R , Ridolfo A L , Salpietro S , Tincati C , Mussini C , Puzzolante C , Gori A , Lapadula G , Abrescia N , Chirianni A , Borgia G , Orlando R , Bonadies G , Martino F Di , Gentile I , Maddaloni L , Cattelan A M , Marinello S , Cascio A , Colomba C , Baldelli F , Schiaroli E , Parruti G , Sozio F , Magnani G , Ursitti M A , Andreoni M , Antinori A , Cauda R , Cristaudo A , Vullo V , Acinapura R , Baldin G , Capozzi M , Cicalini S , Cingolani A , Sulekova L Fontanelli , Iaiani G , Latini A , Mastrorosa I , Plazzi M M , Savinelli S , Vergori A , Cecchetto M , Viviani F , Madeddu G , Bagella P , De Luca A , Rossetti B , Franco A , Del Vecchio R Fontana , Francisci D , Giuli C Di , Caramello P , Perri G Di , Bonora S , Orofino G C , Sciandra M , Bassetti M , Londero A , Pellizzer G , Manfrin V , Starnini G , Ialungo A , Central C , Fontas E , Dollet K , Caissotti C , Dellamonica P , Bernard E , Courjon J , Cua E , De Salvador-Guillouet F , Durant J , Etienne C , Ferrando S , Mondain-Miton V , Naqvi A , Perbost I , Pillet S , Prouvost-Keller B , Pugliese P , Rio V , Risso K , Roger P M , Aubert V , Battegay M , Bernasconi E , Böni J , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Kahlert C , Kaiser L , Keiser O , Klimkait T , Kouyos R D , Kovari H , Ledergerber B , Martinetti G , de Tejada B Martinez , Marzolini C , Metzner K J , Müller N , Nicca D , Pantaleo G , Paioni P , Rauch A , Rudin C , Scherrer A U , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Vernazza P , Wandeler G , Weber R , Yerly S ,   RESPOND cohort study, Wit F , Valk Marc vd , Hillebregt M , Petoumenos K , Law M , Hutchinson J , Rupasinghe D , Han W Min , Zangerle R , Appoyer H , Vera J , Clarke A , Broster B , Barbour L , Carney D , Greenland L , Coughlan R , Saint-Pierre C H U , De Wit S , Delforge M , Begovac J , Wandeler G , Stephan C , Bucht M , Chkhartishvili N , Chokoshvili O , d’Arminio Monforte A , Rodano A , Tavelli A , Fanti I , Mussini C , Borghi V , Pradier C , Fontas E , Dollet K , Caissotti C , Casabona J , Miro J M , Smith C , Lampe F , Johnson M , Burns F , Chaloner C , Castagna A , Spagnuolo V , Muccini C , Nozza S , Lolatto R , Sönnerborg A , Carlander C , Nowak P , Vesterbacka J , Mattsson L , Carrick D , Stigsäter K , Günthard H , Kusejko K , Ledergerber B , Bucher H , Wasmuth J C , Rockstroh J , Vehreschild J J , Fätkenheuer G , Schulze N , Franke B , Ryom Lene , Law M , Rooney J , McNicholl I , Vannappagari V , Garges H , Petoumenos K , Wandeler G , Zangerle R , Smith C , De Wit S , Lundgren J , Günthard H , Young L , Campo R , Lundgren J , Günthard H , Kowalska J , Raben D , Ryom L , Rockstroh J , Peters L , Kirk O , Podlekareva D , Volny-Anne A , Dedes N , Williams E D , Chkhartishvili N , Zangerle R , Petoumenos K , Wit F , Necsoi C , Wandeler G , Stephan C , Pradier C , D’Arminio Monforte A , Mussini C , Bruguera A , Bucher H , Sönnerborg A , Vehreschild J J , Wasmuth J C , Smith C , Castagna A , Vera J , Rooney J , McNicholl I , Vannappagari V , Garges H , Begovac J , Young L , Volny-Anne R Campo Alain , Dedes Nikos , Mendão Luis , Larsen J F , Peters L , Jaschinski N , Timiryasova A , Neesgaard B , Fursa O , Ryom L , Jakobsen M L , Kraef C , Gardizi M , Raben D , Andersen K , Kumar L Ramesh , Elsing T W , Shahi S , Valdenmaiier O , Reekie J , Greenberg L , Bansi-Matharu L , Pelchen-Matthews A , Petoumenos K , Byonanebye D , Tusch E , Bannister W , Roen A 
Published: April 2024

Abstract

Background
Mortality among people with human immunodeficiency virus (HIV) declined with the introduction of combination antiretroviral therapy. We investigated trends in mortality in people with HIV from 1999 through 2020.

Methods
Data were collected from the Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) cohort between January 1999 through January 2015 and the International Cohort Consortium of Infectious Disease (RESPOND) from October 2017 through December 2020. Age-standardized all-cause and cause-specific mortality rates, classified using Coding Causes of Death in HIV, were calculated. Poisson models were used to assess mortality over time.

Results
Among 55 716 participants followed for median 6 years (interquartile range, 3–11), 5263 died (mortality rate [MR], 13.7/1000 person-years of follow-up [PYFU]; 95% confidence interval [CI], 13.4–14.1). Changing mortality was observed: AIDS mortality was most common between 1999–2009 (n = 952; MR, 4.2/1000 PYFU; 95% CI, 4.0–4.5) and non-AIDS–defining malignancy (NADM) between 2010–2020 (n = 444; MR, 2.8/1000 PYFU; 95% CI, 2.5–3.1). In multivariable analysis, all-cause mortality declined (adjusted mortality rate ratio [aMRR], 0.97 per year; 95% CI, .96–.98), mostly 1999–2010 (aMRR, 0.96 per year; 95% CI, .95–.97) but was stable 2011–2020 (aMRR, 1.00 per year; 95% CI, .96–1.05). Mortality due to all known causes except NADM also declined.

Conclusions
Mortality among people with HIV in the D:A:D and/or RESPOND cohorts declined between 1999–2009 and was stable over the period 2010–2020. This decline in mortality was not fully explained by improvements in immunologic–virologic status or other risk factors.