{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T19:53:21Z","timestamp":1764791601976,"version":"3.46.0"},"reference-count":27,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context.\u2014<\/jats:title>\n                    <jats:p>With increasing use and efficacy of antiretroviral therapy for human immunodeficiency virus (HIV) infection, deaths from acquired immunodeficiency syndrome (AIDS)\u2013defining conditions have decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective.\u2014<\/jats:title>\n                    <jats:p>To examine trends in the cause of death of HIV-infected patients who underwent autopsy at a major New York City hospital from 1984 to 2016, a period including the major epochs of the AIDS epidemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design.\u2014<\/jats:title>\n                    <jats:p>Retrospective review of autopsy records and charts with modeling of trends by logistic regression using polynomial models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.\u2014<\/jats:title>\n                    <jats:p>We identified 252 autopsies in adult patients with AIDS (by 1982 definition) or HIV infection. Prior to widespread use of highly active antiretroviral therapy, in 1984\u20131995, on average 13 autopsies per year were done. Post\u2013highly active antiretroviral therapy, the average number of autopsies declined to 4.5 per year. The fitted mean age at death was 35 years in 1984 and increased curvilinearly to 46 years (95% CI, 43\u201349) in 2016 (P &amp;lt; .001). By regression analysis, mean CD4+ T-cell count increased from 6 in 1992 to 64 in 2016 (P = .01). The proportion of AIDS-defining opportunistic infections decreased, from 79% in 1984\u20131987 to 41% in 2008\u20132011 and 29% in 2012\u20132016 (P = .04). The frequency of nonopportunistic infections, however, increased from 37% in 1984\u20131987 to 73% in 2008\u20132011 and 57% in 2012\u20132016 (P = .001). The frequency of AIDS-defining and other malignancies did not change significantly during the study period. The prevalence of atherosclerosis at autopsy rose dramatically, from 21% in 1988\u20131991 to 54% in 2008\u20132011 (P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.\u2014<\/jats:title>\n                    <jats:p>Despite limitations of autopsy studies, many trends in the evolution of the HIV\/AIDS epidemic are readily discernable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5858\/arpa.2019-0144-oa","type":"journal-article","created":{"date-parts":[[2019,8,28]],"date-time":"2019-08-28T11:05:44Z","timestamp":1566990344000},"page":"572-579","source":"Crossref","is-referenced-by-count":7,"title":["Trends in Mortality From Human Immunodeficiency Virus Infection, 1984\u20132016: An Autopsy-Based Study"],"prefix":"10.5858","volume":"144","author":[{"given":"Sobia","family":"Nizami","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Division of Infectious Diseases (Drs Nizami and Holzman) and the Department of Pathology (Dr Rapkiewicz), NYU School of Medicine, New York, New York; CUNY School of Medicine, New York, New York (Ms Morales); and NYU School of Medicine, New York, New York (Ms Hu)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Morales","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Infectious Diseases (Drs Nizami and Holzman) and the Department of Pathology (Dr Rapkiewicz), NYU School of Medicine, New York, New York; CUNY School of Medicine, New York, New York (Ms Morales); and NYU School of Medicine, New York, New York (Ms Hu)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Hu","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Infectious Diseases (Drs Nizami and Holzman) and the Department of Pathology (Dr Rapkiewicz), NYU School of Medicine, New York, New York; CUNY School of Medicine, New York, New York (Ms Morales); and NYU School of Medicine, New York, New York (Ms Hu)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Holzman","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Infectious Diseases (Drs Nizami and Holzman) and the Department of Pathology (Dr Rapkiewicz), NYU School of Medicine, New York, New York; CUNY School of Medicine, New York, New York (Ms Morales); and NYU School of Medicine, New York, New York (Ms Hu)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Rapkiewicz","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Infectious Diseases (Drs Nizami and Holzman) and the Department of Pathology (Dr Rapkiewicz), NYU School of Medicine, New York, New York; CUNY School of Medicine, New York, New York (Ms Morales); and NYU School of Medicine, New York, New York (Ms Hu)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","published-online":{"date-parts":[[2019,8,28]]},"reference":[{"issue":"6","key":"2020081300292464400_i1543-2165-144-5-572-b01","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/hiv.12609","article-title":"Secular trends in opportunistic infections, cancers and mortality in patients with AIDS during the era of modern combination antiretroviral therapy","volume":"19","author":"Sezgin","year":"2018","journal-title":"HIV Med"},{"issue":"1","key":"2020081300292464400_i1543-2165-144-5-572-b02","doi-asserted-by":"publisher","first-page":"1073274818797955","DOI":"10.1177\/1073274818797955","article-title":"Malignancy TRENDS in HIV-infected patients over the past 10 years in a single-center retrospective observational study in the United States","volume":"25","author":"Rihana","year":"2018","journal-title":"Cancer 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Accessed June 12, 2019."},{"issue":"3","key":"2020081300292464400_i1543-2165-144-5-572-b22","doi-asserted-by":"crossref","first-page":"e0151684","DOI":"10.1371\/journal.pone.0151684","article-title":"Association of cytomegalovirus end-organ disease with stroke in people living with HIV\/AIDS: a nationwide population-based cohort study","volume":"11","author":"Yen","year":"2016","journal-title":"PLoS One"},{"issue":"1","key":"2020081300292464400_i1543-2165-144-5-572-b23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/QAD.0b013e328317cc2d","article-title":"Trends in the incidence of cancers among HIV-infected persons and the impact of antiretroviral therapy: a 20-year cohort study","volume":"23","author":"Crum-Cianflone","year":"2009","journal-title":"AIDS"},{"issue":"3","key":"2020081300292464400_i1543-2165-144-5-572-b24","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1038\/sj.bjc.6605756","article-title":"Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study","volume":"103","author":"Franceschi","year":"2010","journal-title":"Br J Cancer"},{"issue":"7","key":"2020081300292464400_i1543-2165-144-5-572-b25","doi-asserted-by":"crossref","first-page":"458","DOI":"10.7326\/M13-1754","article-title":"Associations between HIV infection and subclinical coronary atherosclerosis","volume":"160","author":"Post","year":"2014","journal-title":"Ann Intern Med"},{"issue":"1","key":"2020081300292464400_i1543-2165-144-5-572-b26","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/01.qai.0000233310.90484.16","article-title":"Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study","volume":"43","author":"Palella","year":"2006","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"3","key":"2020081300292464400_i1543-2165-144-5-572-b27","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1097\/QAD.0b013e32835abcc9","article-title":"Atherosclerosis is associated with multiple pathogenic mechanisms in HIV-infected antiretroviral-naive or treated individuals","volume":"27","author":"Piconi","year":"2013","journal-title":"AIDS"}],"container-title":["Archives of Pathology &amp; Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/144\/5\/572\/2500705\/arpa_2019-0144-oa.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/144\/5\/572\/2500705\/arpa_2019-0144-oa.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T19:40:15Z","timestamp":1764790815000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/144\/5\/article-p572.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,28]]},"references-count":27,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,8,28]]},"published-print":{"date-parts":[[2020,5,1]]}},"URL":"https:\/\/doi.org\/10.5858\/arpa.2019-0144-oa","relation":{},"ISSN":["0003-9985","1543-2165"],"issn-type":[{"type":"print","value":"0003-9985"},{"type":"electronic","value":"1543-2165"}],"subject":[],"published":{"date-parts":[[2019,8,28]]}}}