Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 214, Issue 6, Pages 862-872Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiw085
Keywords
AIDS-related opportunistic infections; HIV cohort studies; incidence; prophylaxis; combination antiretroviral therapy; CD4(+) T-lymphocyte count; epidemiology
Categories
Funding
- NIH [U01AI069918, F31DA037788, G12MD007583, K01AI093197, K23EY013707, K24DA000432, K24AI065298, KL2TR000421, M01RR000052, N02CP055504, P30AI027757, P30AI027763, P30AI027767, P30AI036219, P30AI050410, P30AI094189, P30AI110527, P30MH62246, 01AA016893]
- CDC [CDC-200-2006-18797, CDC-200-2015-63931]
- Agency for Healthcare Research and Quality [90047713]
- Health Resources and Services Administration [90051652]
- Canadian Institutes of Health Research [CBR-86906, CBR-94036, HCP-97105, TGF-96118]
- Ontario Ministry of Health and Long Term Care
- Government of Alberta, Canada
- Intramural Research Program of the National Cancer Institute
- THE NIH [R01CA165937, R01DA004334, R01DA011602, R01DA012568, R24AI067039, U01AA013566, U01AA020790, U01AI031834, U01AI034989, U01AI034993, U01AI034994, U01AI035004, U01AI035039, U01AI035040, U01AI035041, U01AI035042, U01AI037613, U01AI037984, U01AI038855, U01AI042590, U01AI068634]
- A NIH [U01AI068636, U01AI069432, U01AI069434, U01AI103390, U01AI103397, U01AI103401, U01AI103408, U01DA036935, U01HD032632, U10EY008057, U10EY008052, U10EY008067, U24AA020794, U54MD007587, UL1RR024131, UL1TR000004, UL1TR000083, UL1TR000454, UM1AI035043, U01AI038858]
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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 studiedHIV-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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