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  • Mortality under plausible i...
    Lesko, Catherine R.; Todd, Jonathan V.; Cole, Stephen R.; Edmonds, Andrew; Pence, Brian W.; Edwards, Jessie K.; Mack, Wendy J.; Bacchetti, Peter; Rubtsova, Anna; Gange, Stephen J.; Adimora, Adaora A.; Saag, Michael; Kempf, Mirjam-Colette; Konkle-Parker, Deborah; Ofotokun, Ighovwerha; Wingood, Gina; Anastos, Kathryn; Minkoff, Howard; Gustafson, Deborah; Cohen, Mardge; French, Audrey; Young, Mary; Kassaye, Seble; Fischl, Margaret; Metsch, Lisa; Adimora, Adaora; Greenblatt, Ruth; Aouizerat, Bradley; Tien, Phyllis; Gange, Stephen; Golub, Elizabeth; Milam, Joel

    Annals of epidemiology, 12/2017, Letnik: 27, Številka: 12
    Journal Article

    Among HIV-infected persons, antiretroviral therapy (ART) and depression are strongly associated with mortality. We estimated reductions in 5-year mortality in Women's Interagency HIV Study participants under plausible hypothetical increases in ART initiation and reductions in depression (CES-D score≥16). We followed 885 ART-naïve Women's Interagency HIV Study participants for 5 years from their first study visit after April 1998 to death or censoring. We used the parametric extended g-formula to estimate cumulative mortality under the natural course (NC) and alternative exposure distributions. Baseline prevalence of depression was 52% and 62% initiated ART by 5 years. Compared with mortality under NC (13.2%), immediate ART and elimination of 36% or 67% of depressive episodes were associated with risk differences (RDs) of −5.2% (95% CI: −7.7%, −2.6%) and −5.7 (95% CI: −8.7, −2.7). Compared with immediate ART and NC for depression, additionally eliminating 67% of the depressive episodes was associated with RD = −1.6 (95% CI: −3.9, 0.8). Compared with 5-year mortality under NC for ART and elimination of 67% of depression, also initiating ART immediately was associated with RD = -2.6 (95% CI: -5.0, -0.3). Increasing ART initiation and reducing depression were associated with moderate reductions in 5-year mortality among HIV-infected women.