A tale of two countries: all‐cause mortality among people living with HIV and receiving combination antiretroviral therapy in the UK and Canada. Issue 9 (24th April 2017)

• Record Type: Journal Article
• Authors: Patterson, S; Jose, S; Samji, H; Cescon, A; Ding, E; Zhu, J; Anderson, J; Burchell, AN; Cooper, C; Hill, T; Hull, M; Klein, MB; Loutfy, M; Martin, F; Machouf, N; Montaner, JSG; Nelson, M; Raboud, J; Rourke, SB; Tsoukas, C; Hogg, RS; Sabin, C
• Other Names: Kelly Deborah investigator.; Sanche Stephen investigator.; Wong Alexander investigator.; Antoniou Tony investigator.; Bayoumi Ahmed investigator.; Nosyk Bohdan investigator.; Cotterchio Michelle investigator.; Goldsmith Charlie investigator.; Guillemi Silvia investigator.; Richard Harrigan P. investigator.; Harris Marianne investigator.; Hosein Sean investigator.; Johnston Sharon investigator.; Liddy Clare investigator.; Lima Viviane investigator.; Moore David investigator.; Palmer Alexis investigator.; Phillips Peter investigator.; Rachlis Anita investigator.; Smieja Marek investigator.; Trottier Benoit investigator.; Wainberg Mark investigator.; Walmsley Sharon investigator.; Archibald Chris investigator.; Clement Ken investigator.; Doolittle‐Romas Monique investigator.; Edmiston Laurie investigator.; Huskins Brian investigator.; Lawless Jerry investigator.; Lee Douglas investigator.; Masching Renee investigator.; Tattle Stephen investigator.; Zahirieh Alireza investigator.; Allen Claire investigator.; Calvez Stryker investigator.; Colley Guillaume investigator.; Chia Jason investigator.; Corsi Daniel investigator.; Gilbert Louise investigator.; Gataric Nada investigator.; Leslie Alia investigator.; Light Lucia investigator.; Mackie David investigator.; Pexos Costa investigator.; Shurgold Susan investigator.; Szadkowski Leah investigator.; Wong John investigator.; Yip Benita investigator.; Younger Jaime investigator.; Ainsworth Jonathan investigator.; Allan Sris investigator.; Babiker Abdel investigator.; Chadwick David investigator.; Delpech Valerie investigator.; Dunn David investigator.; Fisher Martin investigator.; Gazzard Brian investigator.; Gilson Richard investigator.; Gompels Mark investigator.; Hay Phillip investigator.; Johnson Margaret investigator.; Kegg Stephen investigator.; Leen Clifford investigator.; Orkin Chloe investigator.; Palfreeman Adrian investigator.; Phillips Andrew investigator.; Pillay Deenan investigator.; Post Frank investigator.; Pritchard Jillian investigator.; Sachikonye Memory investigator.; Schwenk Achim investigator.; Tariq Anjum investigator.; Walsh John investigator.; Thornton Alicia investigator.; Glabay Adam investigator.; Perry Nicky investigator.; Tilbury Stuart investigator.; Youssef Elaney investigator.; Churchill Duncan investigator.; Everett Rhiannon investigator.; Asboe David investigator.; Mandalia Sundhiya investigator.; Korat Hardik investigator.; Taylor Chris investigator.; Gleisner Zachary investigator.; Ibrahim Fowzia investigator.; Campbell Lucy investigator.; Brima Nataliya investigator.; Williams Ian investigator.; Youle Mike investigator.; Lampe Fiona investigator.; Smith Colette investigator.; Tsintas Rob investigator.; Chaloner Clinton investigator.; Hutchinson Samantha investigator.; Huntington Susie investigator.; Mackie Nicky investigator.; Winston Alan investigator.; Weber Jonathan investigator.; Ramzan Farhan investigator.; Carder Mark investigator.; Lynch Janet investigator.; Hand James investigator.; de Souza Carl investigator.; Munshi Sajid investigator.; Miller Sheila investigator.; Wood Chris investigator.; Wilson Alan investigator.; Morris Sheila investigator.; Allan Sue investigator.; Memon Khurram investigator.; Lewszuk Adam investigator.; Cope Emma investigator.; Gibson Jane investigator.; Main Paul investigator.; Dhillon Mandip investigator.; Russell‐Sharpe Sarah investigator.; Harte Andrew investigator.; Clay Stephen investigator.; Spencer Hazel investigator.; Jones Ron investigator.; Cumming Shirley investigator.; Atkinson Claire investigator.; Trevelion Roy investigator.;
• Is Part Of: HIV medicine. Volume 18:Issue 9(2017:Oct.)
• Page Start: 655
• Page End: 666
• Publication Date: 2017-04-24
• Subjects: AIDS -- antiretroviral therapy -- Canada -- HIV -- mortality -- UK; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12505
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: We sought to compare all‐cause mortality of people living with HIV and accessing care in Canada and the UK. Methods: Individuals from the Canadian Observational Cohort (CANOC) collaboration and UK Collaborative HIV Cohort (UK CHIC) study who were aged ≥ 18 years, had initiated antiretroviral therapy (ART) for the first time between 2000 and 2012 and who had acquired HIV through sexual transmission were included in the analysis. Cox regression was used to investigate the difference in mortality risk between the two cohort collaborations, accounting for loss to follow‐up as a competing risk. Results: A total of 19 960 participants were included in the analysis (CANOC, 4137; UK CHIC, 15 823). CANOC participants were more likely to be older [median age 39 years (interquartile range (IQR): 33, 46 years) vs . 36 years (IQR: 31, 43 years) for UK CHIC participants], to be male (86 vs . 73%, respectively), and to report men who have sex with men (MSM) sexual transmission risk (72 vs . 56%, respectively) (all P < 0.001). Overall, 762 deaths occurred during 98 798 person‐years (PY) of follow‐up, giving a crude mortality rate of 7.7 per 1000 PY [95% confidence interval (CI): 7.1, 8.3 per 1000 PY]. The crude mortality rates were 8.6 (95% CI: 7.4, 10.0) and 7.5 (95% CI: 6.9, 8.1) per 1000 PY among CANOC and UK CHIC study participants, respectively. No statistically significant difference in mortality risk was observed between the cohort collaborations in Cox regression accounting for loss to follow‐up as a competing risk (adjusted hazard ratio 0.86; 95% CI: 0.72–1.03). Conclusions: Despite differences in national HIV care provision and treatment guidelines, mortality risk did not differ between CANOC and UK CHIC study participants who acquired HIV through sexual transmission.