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Changes in mortality following HIV and AIDS and estimation of the number of people living with diagnosed HIV/AIDS in Australia, 1981–2003

Fatemeh Nakhaee A C D , Deborah Black B , Handan Wand A , Ann McDonald A and Matthew Law A

A National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, 376 Victoria Street, Darlinghurst, NSW 2010, Australia.

B Faculty of Health Sciences, University of Sydney, Sydney, NSW 1825, Australia.

C Present address: Department of Biostatistics and Epidemiology, Faculty of Health, Haftbagh Highway, Kerman, Iran.

D Corresponding author. Email:

Sexual Health 6(2) 129-134
Submitted: 19 January 2008  Accepted: 5 February 2009   Published: 18 May 2009


Objective: To investigate changes in mortality following HIV and AIDS in Australia. Methods: The results of a linkage between HIV/AIDS diagnoses and the National Death Index (NDI) to the end of 2003 were used to estimate mortality rates following HIV/AIDS. Standardised Mortality Ratios (SMRs) were calculated for deaths following HIV, with and without AIDS, in three periods of treatment; before antiretroviral therapy (≤1989), pre- and early-HAART (1990–1996) and HAART (1997–2003). Crude mortality rates were calculated as the number of deaths per 1000 person-years. The total number of people living with HIV/AIDS was estimated. Results: There were 1789 deaths following HIV without AIDS and 6730 deaths after AIDS. For deaths following HIV without AIDS, the SMRs were 2.99, 1.22 and 1.6 during the periods before 1990, 1990–1996 and 1997–2003. For deaths after AIDS the SMRs were 137.84, 28.64 and 4.55 in the periods one to three, respectively. The crude death rate following HIV without AIDS increased from 16.8 before 1986 to 19.6 in 2003. Death rates after AIDS decreased from 958.7 up to 1986 to 60.4 in 2003. The number of new HIV diagnoses increased to 1276 in 1990 then decreased to 780 in 2003, while AIDS diagnoses increased to 950 in 1994 then decreased to 252 in 2003. The total number of people living with HIV was estimated to be 7873 in 1989, and 12828 in 2003. Conclusion: Mortality following AIDS decreased while deaths before AIDS remained low. The number of people living with HIV/AIDS has increased.

Additional keywords: antiretroviral treatment, death, mortality rates.


[1]  Blacker J 2004 The impact of AIDS on adult mortality: evidence from national and regional statistics. AIDS 18 Suppl 2 S19 26 doi:10.1097/00002030-200406002-00003

[2]  Mocroft A Vella S Benfield TL Chiesi A Miller V Gargalianos P et al 1998 Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study Group. Lancet 352 1725 30 doi:10.1016/S0140-6736(98)03201-2

[3]  Selik RM Byers RH Jr Dworkin MS 2002 Trends in diseases reported on U.S. death certificates that mentioned HIV infection, 1987–1999. J Acquir Immune Defic Syndr 29 378 87

[4]  Mocroft A Ledergerber B Katlama C Kirk O Reiss P Monforte A et al 2003 Decline in the AIDS and death rates in the EuroSIDA study: an observational study. Lancet 362 22 9

[5]  Vittinghoff E Scheer S O’Malley P Colfax G Holmberg SD Buchbinder SP 1999 Combination antiretroviral therapy and recent declines in AIDS incidence and mortality. J Infect Dis 179 717 20 doi:10.1086/314623

[6]  Messeri P Lee G Abramson DM Aidala A Chiasson MA Jessop DJ 2003 Antiretroviral therapy and declining AIDS mortality in New York City. Med Care 41 512 21 doi:10.1097/00005650-200304000-00007

[7]  Krentz HB Kliewer G Gill MJ 2005 Changing mortality rates and causes of death for HIV-infected individuals living in Southern Alberta, Canada from 1984 to 2003. HIV Med 6 99 106 doi:10.1111/j.1468-1293.2005.00271.x

[8]  Valdez H Chowdhry TK Asaad R Woolley IJ Davis T Davidson R et al 2001 Changing spectrum of mortality due to human immunodeficiency virus: analysis of 260 deaths during 1995–1999. Clin Infect Dis 32 1487 93 doi:10.1086/320164

[9]  Palella FJ Jr Delaney KM Moorman AC Loveless MO Fuhrer J Satten GA et al 1998 Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med 338 853 60 doi:10.1056/NEJM199803263381301

[10]  Bloch M , Grulich A , Effler P , Luo K , Kaldor J . Anti-retroviral (ARV) therapies in 471 HIV positive patients in Sydney and Melbourne-treatment and attitudes [abstract]. In: Australian Society for HIV Medicine Inc 7th Annual Conference; 1995 Nov. 16–19; Coolum, Queensland. Abstract number: 87; 1995.

[11]  Fagan D , Phillips S , Smith DE , Duncombe C , Anderson B , Buchanan A et al. An observational study of antiretroviral treatment in HIV-infected patients attending general practices in Australia in 1995 [abstract]. In: 3rd International Congress on Drug Therapy in HIV Infection; 1996 Nov. 3–7; Birmingham, UK. Abstract AIDS, 1996, 10 Suppl 2: S30.

[12]  Correll PK Law MG McDonald AM Cooper DA Kaldor JM 1998 HIV disease progression in Australia in the time of combination antiretroviral therapies. Med J Aust 169 469 72

[13]  Petoumenos K 2003 The role of observational data in monitoring trends in antiretroviral treatment and HIV disease stage: results from the Australian HIV observational database. J Clin Virol 26 209 22

[14]  Louie JK Hsu LC Osmond DH Katz MH Schwarcz SK 2002 Trends in causes of death among persons with acquired immunodeficiency syndrome in the era of highly active antiretroviral therapy, San Francisco, 1994–1998. J Infect Dis 186 1023 7

[15]  Bonnet F Morlat P Chene G Mercie P Neau D Chossat I et al 2002 Causes of death among HIV-infected patients in the era of highly active antiretroviral therapy, Bordeaux, France, 1998–1999. HIV Med 3 195 9

[16]  Jain MK Skiest DJ Cloud JW Jain CL Burns D Berggren RE 2003 Changes in mortality related to human immunodeficiency virus infection: comparative analysis of inpatient deaths in 1995 and in 1999–2000. Clin Infect Dis 36 1030 8 doi:10.1086/368186

[17]  Kaldor J McDonald AM Blumer CE Gertig DM Patten JJ Roberts M et al 1993 The acquired immunodeficiency syndrome in Australia: incidence 1982–1991. Med J Aust 158 10 7

[18]  McDonald AM Crofts N Blumer CE Gertig DM Patten JJ Roberts M et al 1994 The pattern of diagnosed HIV infection in Australia, 1984–1992. AIDS 8 513 20

[19]  Nakhaee F McDonald A Black D Law M 2007 A feasible method for linkage studies avoiding clerical review: linking of the national HIV/AIDS surveillance databases with National Death Index in Australia. Aust N Z J Public Health 31 308 12 doi:10.1111/j.1753-6405.2007.00076.x

[20]  Australian Bureau of Statistics. Population by age and sex, Australian States and Territories. Canberra: Australian Bureau of Statistics; 2003.

[21]  Larsen SO 1994 Estimation of the number of people in a register from the number of birthdates. Stat Med 13 177 83 doi:10.1002/sim.4780130208

[22]  Law MG McDonald MA Kaldor JM 1996 Estimation of cumulative HIV incidence in Australia, based on national case reporting. Aust N Z J Public Health 20 215 7 doi:10.1111/j.1753-6405.1996.tb01822.x

[23]  Law MG Rosenberg PS McDonald A Kaldor JM 1996 Age-specific HIV incidence among homosexually active men in Australia. Med J Aust 164 715 8

[24]  Brookmeyer R Liao JG 1990 The analysis of delays in disease reporting: methods and results for the acquired immunodeficiency syndrome. Am J Epidemiol 132 355 65

[25]  Schanzer DL 2003 HIV/AIDS mortality in trends in Canada, 1987–1998. Can J Public Health 94 135 9

[26]  Prins M Sabin CA Lee CA Devereux H Coutinho RA 2000 Pre-AIDS mortality and its association with HIV disease progression in haemophilic men, injecting drug users and homosexual men. AIDS 14 1829 37

[27]  Laurichesse HA Mortimer J Evans BG Farrington CP 1998 Pre-AIDS mortality in HIV-infected individuals in England, Wales and Northern Ireland, 1982–1996. AIDS 12 651 8 doi:10.1097/00002030-199806000-00015

[28]  Mocroft A Brettle R Kirk O Blaxhult A Parkin JM Antunes F et al 2002 Changes in the cause of death among HIV positive subjects across Europe: results from the EuroSIDA study. AIDS 16 1663 71 doi:10.1097/00002030-200208160-00012

[29]  Vandentorren S Mercie P Marimoutou C Neau D Malvy D Farbos S et al 2001 Trends in causes of death in the Aquitaine cohort of HIV-infected patients, 1995–1997. Eur J Epidemiol 17 7 10 doi:10.1023/A:1010972410865

[30]  Law MG Prestage G Grulich A Van de Ven P Kippax S 2001 Modelling the effect of combination antiretroviral treatments on HIV incidence. AIDS 15 1287 94 doi:10.1097/00002030-200107060-00011

[31]  Clements MS Prestage G Grulich A Van de Ven P Kippax S Law MG 2004 Modeling trends in HIV incidence among homosexual men in Australia 1995–2006. J Acquir Immune Defic Syndr 35 401 6 doi:10.1097/00126334-200404010-00010

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