Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010

North American Aids Cohort Collaboration On Research And Design (na-Accord) Of IeDEA

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)862-872
Number of pages11
JournalJournal of Infectious Diseases
Volume214
Issue number6
DOIs
StatePublished - Sep 15 2016

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Keywords

  • AIDS-related opportunistic infections
  • CD4 T-lymphocyte count
  • HIV cohort studies
  • combination antiretroviral therapy
  • epidemiology
  • incidence
  • prophylaxis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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