[Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)]. / Muertes por enfermedades no asociadas directamente con el sida en pacientes con infección por el VIH: un estudio de 14 años (1998-2011).

BACKGROUND AND OBJECTIVE: The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. PATIENTS AND METHODS: Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. RESULTS: A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%; P<.001) and higher mortality from NAEs (68% vs 45%; P=.006). There was a very sharp increase in non-AIDS-defining cancers (18.5% vs 2.1%, p=001), and increased deaths from cardiovascular disease (9.2% vs 2.1%, P=.06). Patients who died in the second period were older, and had a better immunological and virological status at cohort entry and before death. They received antiretroviral therapy (ART) more often and were more often virologically suppressed before death (61.5% vs 24%; P=.001). CONCLUSIONS: Non-AIDS-defining cancers, unnatural deaths, and cardiovascular diseases are now major causes of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression.

First human systemic infection caused by Spiroplasma.

Spiroplasma species are organisms that normally colonize plants and insects. We describe the first case of human systemic infection caused by Spiroplasma bacteria in a patient with hypogammaglobulinemia undergoing treatment with biological disease-modifying antirheumatic agents. Spiroplasma turonicum was identified through molecular methods in several blood cultures. The infection was successfully treated with doxycycline plus levofloxacin.

Muertes por enfermedades no asociadas directamente con el sida en pacientes con infección por el VIH: un estudio de 14 años (1998-2011) / Deaths due to non-AIDS diseases among HIV infected patients: A 14-year study (1998-2011)

FUNDAMENTO Y OBJETIVO: El objetivo del estudio fue analizar las muertes por enfermedades no asociadas directamente con el sida en una cohorte de pacientes con VIH atendidos entre 1998 y 2011. Pacientes y método: La información sobre las causas de la muerte se recogió retrospectivamente y se clasificaron siguiendo el algoritmo CoDe. Se compararon las características de los pacientes en 2 periodos: 1998-2004 y 2005-2011. Resultados: Fallecieron 159 de los 1.070 pacientes atendidos en ese espacio de tiempo, 56 (35%) por eventos sida y 86 (54%) por eventos no sida (ENOS); en 17 (11%) no pudo determinarse la causa. Globalmente, las principales causas de muerte fueron infecciones (32%), neoplasias (17%) y muertes no naturales (17%). Durante el segundo período hubo menor mortalidad por sida (18,5 vs 47%; p < 0,001) y mayor mortalidad por ENOS (68 vs 45%; p = 0,006). Se produjo un aumento muy acusado de las neoplasias no asociadas a sida (18,5 vs 2,1%; p = 0,001) y aumentaron las muertes por enfermedad cardiovascular (9,2 vs 2,1%; p = 0,06). Los pacientes que murieron en el segundo periodo tenían mayor edad, mejor situación inmunovirológica a la entrada en la cohorte y antes de fallecer, recibieron tratamiento antirretroviral (TAR) con mayor frecuencia, y estaban más a menudo suprimidos virológicamente antes del fallecimiento (61,5 vs 24%; p < 0,001). Conclusiones: Las neoplasias no asociadas a sida, las muertes no naturales y los eventos cardiovasculares constituyen ahora causas importantes de muerte en los pacientes con VIH. En los últimos años la mayoría de los pacientes fallecidos están en TAR y suprimidos virológicamente

BACKGROUND AND OBJECTIVE: The objective of this study was to analyze the deaths caused by non-AIDS diseases in a cohort of HIV-infected patients treated between 1998 and 2011. PATIENTS AND METHODS: Information on the causes of death was collected retrospectively, and then classified according to the deaths code (CoDe) algorithm. Patient characteristics and causes of death were compared for two periods: 1998-2004 and 2005-2011. RESULTS: A total of 159 out of the 1070 patients cared for in study period died, 56 (35%) due to AIDS events and 86 (54%) due to non-AIDS events (NAEs); in 17 (11%) the cause of death could not be determined. Overall, the main causes of death were infections (32%), cancer (17%), and unnatural deaths (17%). There was lower mortality from AIDS-related conditions during the second period (18.5% vs 47%;P < .001) and higher mortality from NAEs (68% vs 45%; P = .006). There was a very sharp increase in non-AIDS-defining cancers (18.5% vs 2.1%, p = 001), and increased deaths from cardiovascular disease (9.2% vs 2.1%, P = .06). Patients who died in the second period were older, and had a better immunological and virological status at cohort entry and before death. They received antiretroviral therapy (ART) more often and were more often virologically suppressed before death (61.5% vs 24%;P = .001). CONCLUSIONS: Non-AIDS-defining cancers, unnatural deaths, and cardiovascular diseases are now major causes of death in patients with HIV. In recent years the majority of deceased patients are on ART and with virological suppression