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Cause-Specific Excess Mortality in Siblings of Patients Co-Infected with HIV and Hepatitis C Virus

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dc.contributor.author Hansen, Ann-Brit Eg en_US
dc.contributor.author Lohse, Nicolai en_US
dc.contributor.author Gerstoft, Jan en_US
dc.contributor.author Kronborg, Gitte en_US
dc.contributor.author Laursen, Alex en_US
dc.contributor.author Pedersen, Court en_US
dc.contributor.author Sørensen, Henrik Toft en_US
dc.contributor.author Obel, Niels en_US
dc.date.accessioned 2012-01-11T22:22:16Z
dc.date.available 2012-01-11T22:22:16Z
dc.date.issued 2007-8-15 en_US
dc.identifier.citation Hansen, Ann-Brit Eg, Nicolai Lohse, Jan Gerstoft, Gitte Kronborg, Alex Laursen, Court Pedersen, Henrik Toft Sørensen, Niels Obel. "Cause-Specific Excess Mortality in Siblings of Patients Co-Infected with HIV and Hepatitis C Virus" PLoS ONE2(8): e738. (2007) en_US
dc.identifier.issn 1932-6203 en_US
dc.identifier.uri http://hdl.handle.net/2144/3269
dc.description.abstract BACKGROUND. Co-infection with hepatitis C in HIV-infected individuals is associated with 3- to 4-fold higher mortality among these patients' siblings, compared with siblings of mono-infected HIV-patients or population controls. This indicates that risk factors shared by family members partially account for the excess mortality of HIV/HCV-co-infected patients. We aimed to explore the causes of death contributing to the excess sibling mortality. METHODOLOGY AND PRINCIPAL FINDINGS. We retrieved causes of death from the Danish National Registry of Deaths and estimated cause-specific excess mortality rates (EMR) for siblings of HIV/HCV-co-infected individuals (n=436) and siblings of HIV mono-infected individuals (n=1837) compared with siblings of population controls (n=281,221). Siblings of HIV/HCV-co-infected individuals had an all-cause EMR of 3.03 (95% CI, 1.56-4.50) per 1,000 person-years, compared with siblings of matched population controls. Substance abuse-related deaths contributed most to the elevated mortality among siblings [EMR=2.25 (1.09-3.40)] followed by unnatural deaths [EMR=0.67 (-0.05-1.39)]. No siblings of HIV/HCV co-infected patients had a liver-related diagnosis as underlying cause of death. Siblings of HIV-mono-infected individuals had an all-cause EMR of 0.60 (0.16-1.05) compared with siblings of controls. This modest excess mortality was due to deaths from an unknown cause [EMR=0.28 (0.07-0.48)], deaths from substance abuse [EMR=0.19 (-0.04-0.43)], and unnatural deaths [EMR=0.18 (-0.06-0.42)]. CONCLUSIONS. HCV co-infection among HIV-infected patients was a strong marker for family-related mortality due to substance abuse and other unnatural causes. To reduce morbidity and mortality in HIV/HCV-co-infected patients, the advances in antiviral treatment of HCV should be accompanied by continued focus on interventions targeted at substance abuse-related risk factors. en_US
dc.description.sponsorship Danish AIDS Foundation; Odense University Hospital; Preben and Anna Simonsen’s Foundation; the Foundation of the Danish Association of Pharmacists; the Clinical Institute at the University of Southern Denmark en_US
dc.language.iso en en_US
dc.publisher Public Library of Science en_US
dc.title Cause-Specific Excess Mortality in Siblings of Patients Co-Infected with HIV and Hepatitis C Virus en_US
dc.type article en_US
dc.identifier.doi 10.1371/journal.pone.0000738 en_US
dc.identifier.pubmedid 17710138 en_US
dc.identifier.pmcid 1939735 en_US


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