Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula

WIHS Investigators; WIHS Investigators

doi:10.1016/j.annepidem.2017.08.021

Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula

WIHS Investigators, WIHS Investigators

Mailman School of Public Health

Producción científica › revisión exhaustiva

8 Citas (Scopus)

Resumen

Purpose 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). Methods 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. Results 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). Conclusions Increasing ART initiation and reducing depression were associated with moderate reductions in 5-year mortality among HIV-infected women.

Idioma original	English
Páginas (desde-hasta)	783-789.e2
Publicación	Annals of Epidemiology
Volumen	27
N.º	12
DOI	https://doi.org/10.1016/j.annepidem.2017.08.021
Estado	Published - dic. 2017

Financiación

Data in this manuscript were collected by the Women's Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). WIHS (Principal Investigators): UAB-MS WIHS (Michael Saag, Mirjam-Colette Kempf, and Deborah Konkle-Parker), U01-AI-103401; Atlanta WIHS (Ighovwerha Ofotokun and Gina Wingood), U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Mary Young and Seble Kassaye), U01-AI-034994; Miami WIHS (Margaret Fischl and Lisa Metsch), U01-AI-103397; UNC WIHS (Adaora Adimora), U01-AI-103390; Connie Wofsy Women's HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (Joel Milam), U01-HD-032632 (WIHS I–WIHS IV). The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and other Communication Disorders (NIDCD), and the NIH Office of Research on Women's Health. WIHS data collection is also supported by UL1-TR000004 (UCSF CTSA) and UL1-TR000454 (Atlanta CTSA). Funding: This analysis was supported by National Institutes of Health grants U01 AI103390, R01 AI100654 and U01 HL121812.

Financiadores	Número del financiador
National Institutes of Health	R01 AI100654, U01 HL121812, U01 AI103390
National Institute of Mental Health
National Institute on Drug Abuse
National Institute on Alcohol Abuse and Alcoholism
National Cancer Institute
National Institute on Deafness and Other Communication Disorders
National Institute of Allergy and Infectious Diseases	U01AI031834
National Institute of Dental and Craniofacial Research
Office of Research on Women's Health	UL1-TR000004
University of California, San Francisco	UL1-TR000454
Eunice Kennedy Shriver National Institute of Child Health and Human Development

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Epidemiology

ODS de las Naciones Unidas

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@article{09def3da540541f194cfba82b7d8be7b,

title = "Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula",

abstract = "Purpose 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). Methods We followed 885 ART-na{\"i}ve 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. Results 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). Conclusions Increasing ART initiation and reducing depression were associated with moderate reductions in 5-year mortality among HIV-infected women.",

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

note = "Publisher Copyright: {\textcopyright} 2017 Elsevier Inc.",

year = "2017",

month = dec,

doi = "10.1016/j.annepidem.2017.08.021",

language = "English",

volume = "27",

pages = "783--789.e2",

journal = "Annals of Epidemiology",

issn = "1047-2797",

publisher = "Elsevier Inc.",

number = "12",

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TY - JOUR

T1 - Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women

T2 - an application of the parametric g-formula

AU - WIHS Investigators

AU - Lesko, Catherine R.

AU - Todd, Jonathan V.

AU - Cole, Stephen R.

AU - Edmonds, Andrew

AU - Pence, Brian W.

AU - Edwards, Jessie K.

AU - Mack, Wendy J.

AU - Bacchetti, Peter

AU - Rubtsova, Anna

AU - Gange, Stephen J.

AU - Adimora, Adaora A.

AU - Saag, Michael

AU - Kempf, Mirjam Colette

AU - Konkle-Parker, Deborah

AU - Ofotokun, Ighovwerha

AU - Wingood, Gina

AU - Anastos, Kathryn

AU - Minkoff, Howard

AU - Gustafson, Deborah

AU - Cohen, Mardge

AU - French, Audrey

AU - Young, Mary

AU - Kassaye, Seble

AU - Fischl, Margaret

AU - Metsch, Lisa

AU - Adimora, Adaora

AU - Greenblatt, Ruth

AU - Aouizerat, Bradley

AU - Tien, Phyllis

AU - Golub, Elizabeth

AU - Milam, Joel

PY - 2017/12

Y1 - 2017/12

N2 - Purpose 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). Methods 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. Results 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). Conclusions Increasing ART initiation and reducing depression were associated with moderate reductions in 5-year mortality among HIV-infected women.

AB - Purpose 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). Methods 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. Results 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). Conclusions Increasing ART initiation and reducing depression were associated with moderate reductions in 5-year mortality among HIV-infected women.

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DO - 10.1016/j.annepidem.2017.08.021

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AN - SCOPUS:85029567856

SN - 1047-2797

VL - 27

SP - 783-789.e2

JO - Annals of Epidemiology

JF - Annals of Epidemiology

IS - 12

ER -

Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula

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ASJC Scopus Subject Areas

ODS de las Naciones Unidas

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