Publication date: Jul 10, 2023

To assess updated mortality and causes of death in people living with HIV (PLWH) in France. We analyzed all deaths in PLWH followed up between 01/01/2020 and 31/12/2021 in 11 hospitals in the Paris region. We described the characteristics and causes of death among deceased PLWH, and evaluated the incidence of mortality and associated risk factors using a multivariate logistic regression. Of the 12942 patients followed in 2020-2021, 202 deaths occurred. Mean annual incidence of death (95% confidence interval [CI]) was 7. 8 per 1 000 PLWH (6. 3-9. 5). Forty-seven patients (23%) died from non-AIDS non-viral hepatitis (NANH)-related malignancies, 38 (19%) from non-AIDS infections (including 21 cases of COVID-19), 20 (10%) from AIDS, 19 (9%) from cardiovascular diseases (CVD), 17 (8. 4%) from other causes, six (3%) from liver diseases and five (2. 5%) from suicides/violent deaths. The cause of death was unknown in 50 (24. 7%) patients. Risks factors for death were age (adjusted Odds Ratio (aOR) 1. 93; 1. 66-2. 25 by additional decade), AIDS history (2. 23; 1. 61-3. 09), low CD4 (1. 95; 1. 36-2. 78 for 200-500/μL and 5. 76; 3. 65-9. 08 for ≤ 200/μL versus > 500/μL), and viral load > 50 copies/mL (2. 03; 1. 33-3. 08), both at last visit. NANH malignancies remained in 2020-2021 the first cause of death. COVID-19 accounted for more than half of the mortality related to non-AIDS infections over the period. Aging, AIDS history, and a poorer viro-immunological control were associated with death.

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