Liver‐related deaths in <scp>HIV</scp>‐infected patients between 1995 and 2010 in <scp>F</scp>rance: the <scp>M</scp>ortavic 2010 study in collaboration with the <scp>A</scp>gence <scp>N</scp>ationale de <scp>R</scp>echerche sur le <scp>SIDA</scp> (<scp>ANRS</scp>) <scp>EN</scp> 20 <scp>M</scp>ortalité 2010 survey

<jats:sec><jats:title>Objectives</jats:title><jats:p>The aim of this study was to describe the proportion of liver‐related diseases (<jats:styled-content style="fixed-case">LRD</jats:styled-content>s) as a cause of death in <jats:styled-content style="fixed-case">HIV</jats:styled-content>‐infected patients in <jats:styled-content style="fixed-case">F</jats:styled-content>rance and to compare the results with data from our five previous surveys.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In 2010, 24 clinical wards prospectively recorded all deaths occurring in around 26 000 <jats:styled-content style="fixed-case">HIV</jats:styled-content>‐infected patients who were regularly followed up. Results were compared with those of previous cross‐sectional surveys conducted since 1995 using the same design.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 230 reported deaths, 46 (20%) were related to <jats:styled-content style="fixed-case">AIDS</jats:styled-content> and 30 (13%) to chronic liver diseases. Eighty per cent of patients who died from <jats:styled-content style="fixed-case">LRD</jats:styled-content>s had chronic hepatitis <jats:styled-content style="fixed-case">C</jats:styled-content>, 16.7% of them being coinfected with hepatitis <jats:styled-content style="fixed-case">B</jats:styled-content> virus (<jats:styled-content style="fixed-case">HBV</jats:styled-content>). Among patients who died from an <jats:styled-content style="fixed-case">LRD</jats:styled-content>, excessive alcohol consumption was reported in 41%. At death, 80% of patients had undetectable <jats:styled-content style="fixed-case">HIV</jats:styled-content> viral load and the median CD4 cell count was 349 cells/μL. The proportion of deaths and the mortality rate attributable to <jats:styled-content style="fixed-case">LRDs</jats:styled-content> significantly increased between 1995 and 2005 from 1.5% to 16.7% and from 1.2‰ to 2.0‰, respectively, whereas they tended to decrease in 2010 to 13% and 1.1‰, respectively. Among liver‐related causes of death, the proportion represented by hepatocellular carcinoma (<jats:styled-content style="fixed-case">HCC</jats:styled-content>) dramatically increased from 5% in 1995 to 40% in 2010 (p = 0.019).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The proportion of <jats:styled-content style="fixed-case">LRD</jats:styled-content>s among causes of death in <jats:styled-content style="fixed-case">HIV</jats:styled-content>‐infected patients seems recently to have reached a plateau after a rapid increase during the decade 1995−2005. <jats:styled-content style="fixed-case">LRD</jats:styled-content>s remain a leading cause of death in this population, mainly as a result of hepatitis <jats:styled-content style="fixed-case">C</jats:styled-content> virus (<jats:styled-content style="fixed-case">HCV</jats:styled-content>) coinfection, <jats:styled-content style="fixed-case">HCC</jats:styled-content> representing almost half of liver‐related causes of death.</jats:p></jats:sec>