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Mortality and cause of death among HIV patients in London in 2016: 77% Die of Non-AIDS Conditions/Comorbidities/majority virally suppressed - Ending AIDS? Only applies to stopping new transmissions?
  Reported by Jules Levin
22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018
S.Croxford1, R. Miller2, F. Post3, J. Figueroa1,4, I. Harrison4, R. Harding3, V. Delpech1, S. Lucas5, S. Dhoot6 and A. Sullivan6 on behalf of the London Mortality Study Group
1 Public Health England, London, UK
2 CNWL NHS Foundation Trust, London, UK
3 King's College Hospital NHS Foundation Trust, London, UK
4 NHS England, London, UK
5 Guys & St. Thomas NHS Foundation Trust, London, UK
6 Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
is Ending AIDS Possible? what is the definition of Ending AIDS: reduced new transmissions to very low levels? OK but death rates among HIV+ is a problem & is likely to remain a problem with the Aging HIV+ POPULATION & the issues surrounding comorbidities, frailty, disability and accelerated aging. Many fail to recognize that Ending AIDS includes people living with HIV and improving their lifespan & quality of life. Jules
"over three quarters (77%) of deaths were due to non-AIDS conditions and the majority of patients were on ART and virally suppressed at their last clinic visit .....number of potentially avoidable deaths were identified, highlighting the need for improvement in testing rates, optimal management of comorbidities and strong psycho-social support......improvements are necessary in end-of-life care planning and in collaborative decision making with patients and other specialties, such as oncology and cardiology......At the time of death, 81% (134/165) of people were on ART, 61% (113/185) had a CD4 count of <350 cells/mm3 and 24% (47/192) a viral load of ≥200 copies/ml. .......Co-morbidities were commonly reported (n=200): 39% of patients had a history of depression, 33% had chronic hypertension, 27% had dyslipidemia, 18% had co-infection with HBV and/or HCV and 14% had diabetes (Figure 4)......79% (46/58) were reported to have an undetectable viral load at death (<200 copies/mL).....Among people who died unexpectedly, 18% (9/50) died of accident/suicide, 16% (8/50) died of cardiovascular disease and 14% (7/50) died of non-AIDS malignancies. In contrast, people who died expectedly more commonly died of liver disease (29%; 30/103) and AIDS-defining illnesses (27%; 28/103)."