AIDS: 1 in 4 Die of Other Things

Because of the success of anti-HIV drugs, it is becoming less common for people with AIDS to actually die of causes related to the disease, according to a New York study.

Experts from New York City's Bureau of HIV/AIDS Prevention and Control report that finding in the Annals of Internal Medicine.

Judith Sackoff, PhD, and colleagues tracked all people aged 13 and older in New York City known to have AIDS -- more than 68,600 people -- between 1999 and 2004.

During that time, a total of 12,715 New Yorkers known to have AIDS died.

Nearly three-fourths of those deaths were linked to HIV.

But more than 3,000 weren't related to HIV, according to death certificate information. The percentage of deaths not linked to HIV rose by 33% over the course of the study, Sackoff and colleagues report.

The three top unrelated causes of death were substance abuse, heart disease, and non-AIDS defining cancer.

HIV Still Deadly

"Although HIV-related causes accounted for most deaths, the proportion of deaths due to non-HIV-related causes increased by 33% and accounted for approximately one-fourth of all deaths of persons with AIDS during this period," the researchers write.

They credit antiretroviral drugs for the shift and note that, while death certificate information may not be perfect, many non-HIV-related deaths were "preventable."

It may be time to broaden the main focus of care for AIDS patients to include "all aspects of physical and mental health," write Sackoff and colleagues.

New York University's Judith Aberg, MD, agrees in an Annals of Internal Medicine editorial.
"Developed countries are experiencing an epidemic of conditions: obesity, CHD [coronary heart disease], diabetes, and lung cancer,"
Aberg writes, in the editorial.

Doctors "must remember that most of their HIV-infected patients will survive to develop the diseases that plague the rest of us," Aberg writes.

That may not be true for people who don't have access to antiretroviral drugs.

More than 3 million people worldwide died of AIDS in 2005, according to the World Health Organization.

While global access to antiretroviral drugs has improved, millions of people worldwide still don't get those drugs.

"At best, one in 10 Africans and one in seven Asians in need of antiretroviral treatment were receiving it in mid-2005," states the World Health Organization's most recent "AIDS Epidemic Update," dated December 2005.

SOURCES: Sackoff, J. Annals of Internal Medicine, Sept. 19, 2006; vol 145: pp 397-406. Aberg, J. Annals of Internal Medicine, Sept. 19, 2006; vol 145: pp 463-464. World Health Organization: "AIDS Epidemic Update 2005." News release, American College of Physicians.