Journal
AIDS
Volume 26, Issue 14, Pages 1829-1834Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e328352ada4
Keywords
AIDS; causes of death; hepatitis; HIV; malignancies; mortality
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Funding
- Instituto de Salud Carlos III through the Red Tematica de Investigacion Cooperativa en Sida [RIS C03/173]
- UK Medical Research Council [G0700820]
- FIS (Spanish Networks for Research on AIDS and Public Health) [04/0900]
- RIS (Spanish HIV Research Network for excellence) [RD06/006]
- CIBERESP (Ciber de Epidemiologia y Salud Publica)
- Medical Research Council [G0700820] Funding Source: researchfish
- MRC [G0700820] Funding Source: UKRI
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Objectives: To compare causes of death (CoDs) from two independent sources: National Basic Death File (NBDF) and deaths reported to the Spanish HIV Research cohort [Cohort de adultos con infeccion por VIH de la Red de Investigacion en SIDA CoRIS)] and compare the two coding algorithms: International Classification of Diseases, 10th revision (ICD-10) and revised version of Coding Causes of Death in HIV (revised CoDe). Methods: Between 2004 and 2008, CoDs were obtained from the cohort records (free text, multiple causes) and also from NBDF (ICD-10). CoDs from CoRIS were coded according to ICD-10 and revised CoDe by a panel. Deaths were compared by 13 disease groups: HIV/AIDS, liver diseases, malignancies, infections, cardiovascular, blood disorders, pulmonary, central nervous system, drug use, external, suicide, other causes and ill defined. Results: There were 160 deaths. Concordance for the 13 groups was observed in 111 (69%) cases for the two sources and in 115 (72%) cases for the two coding algorithms. According to revised CoDe, the commonest CoDs were HIV/AIDS (53%), non-AIDS malignancies (11%) and liver related (9%), these percentages were similar, 57, 10 and 8%, respectively, for NBDF (coded as ICD-10). When using ICD-10 to code deaths in CoRIS, wherein HIV infection was known in everyone, the proportion of non-AIDS malignancies was 13%, liver-related accounted for 3%, while HIV/AIDS reached 70% due to liver-related, infections and ill-defined causes being coded as HIV/AIDS. Conclusion: There is substantial variation in CoDs in HIV-infected persons according to sources and algorithms. ICD-10 in patients known to be HIV-positive overestimates HIV/AIDS-related deaths at the expense of underestimating liver-related diseases, infections and ill defined causes. CoDe seems as the best option for cohort studies. (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
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