ArticleJournal of the International AIDS Society2021
Accounting for misclassified and unknown cause of death data in vital registration systems for estimating trends in HIV mortality.
Article in Journal of the International AIDS Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Excess mortality attributable to AIDS among people living with HIV in high-income countries: a systematic review and meta-analysis.Journal of the International AIDS Society · 2024Pooled it
- A combined eGFR-CD4 index and mortality risk among people with HIV: a retrospective cohort study in Taizhou city, Zhejiang province, China.AIDS research and therapy · 2026Article
- Enhancing identification of suspected unregulated drug toxicity deaths in administrative health records: a case study among people with HIV in British Columbia, Canada.BMC public health · 2026Article
- Accounting for Misclassification of Cause of Death in Weighted Cumulative Incidence Functions for Causal Analyses.Statistics in medicine · 2025Article
- Trends and disparities in human immunodeficiency virus and chronic liver disease mortality in the United States: A nationwide analysis.The Journal of international medical research · 2025Article
- Global, regional, and national burden of HIV/AIDS, 1990-2021, and forecasts to 2050, for 204 countries and territories: the Global Burden of Disease Study 2021.The lancet. HIV · 2024Article
- The Global Burden of Disease Study tuberculosis estimates from the Institute for Health Metrics and Evaluation.International journal of epidemiology · 2024Article
- Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000-2021: a systematic analysis from the Global Burden of Disease Study 2021.The Lancet. Haematology · 2023Article
- Addressing the Data Gaps on Child and Adolescent Tuberculosis.Pathogens (Basel, Switzerland) · 2022Review
- Refining global HIV estimates for decision-making: advances in analytic and modelling methods used by the Joint United Nations Programme on HIV/AIDS.Journal of the International AIDS Society · 2021Article
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Authors and funding
14 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
introductionMisclassification of HIV deaths can substantially diminish the usefulness of cause of death data for decision-making. In this study, we describe the methods developed by the Global Burden of Disease Study to account for the misclassified cause of death data from vital registration systems for estimating HIV mortality in 132 countries and territories.
methodsThe cause of death data were obtained from the World Health Organization Mortality Database and official country-specific mortality databases. We implemented two steps to adjust the raw cause of death data: (1) redistributing garbage codes to underlying causes of death, including HIV/AIDS by applying methods, such as analysis of multiple cause data and proportional redistribution, and (2) reassigning HIV deaths misclassified as other causes to HIV/AIDS by examining the age patterns of underlying causes in location and years with and without HIV epidemics.
resultsIn 132 countries, during the period from 1990 to 2018, 1,848,761 deaths were reported as caused by HIV/AIDS. After garbage code redistribution in these 132 countries, this number increased to 4,165,015 deaths. An additional 1,944,291 deaths were added through correction of HIV deaths misclassified as other causes in 44 countries. The proportion of HIV deaths derived from garbage code redistribution decreased over time, from 0.4 in 1990 to 0.1 in 2018. The proportion of deaths derived from HIV misclassification correction peaked at 0.4 in 2006 and declined afterwards to 0.08 in 2018. The greatest contributors to garbage code redistribution were "immunodeficiency antibody" (ICD 9: 279-279.1; ICD 10: D80-D80.9) and "immunodeficiency other" (ICD 9: 279, 279.5-279.9; ICD 10: D83-D84.9, D89, D89.8-D89.9), which together contributed 77% of all redistributed deaths at their peak in 1995. Respiratory tuberculosis (ICD 9: 010-012.9; ICD 10: A10-A14, A15-A16.9) contributed the greatest proportion of all HIV misclassified deaths (25-62% per year) over the most years.
conclusionsCorrecting for miscoding and misclassification of cause of death data can enhance the utility of the data for analyzing trends in HIV mortality and tracking progress toward the Sustainable Development Goal targets.
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