People with AIDS are increasingly dying of unrelated diseases

People with AIDS are living longer, thanks to highly active retroviral treatment, and an increasing proportion are surviving their infection long enough to die of unrelated illnesses such as cardiovascular disease. This is certainly true in New York city, where recent research shows that more than a quarter of people with AIDS die from something else—mostly drug overdose, heart disease, or a cancer unrelated to HIV infection.

This proportion increased by a third (from 19.8% to 26.3%, P = 0.015) between 1999 and 2004. The authors and a linked editorial agree there is a growing need for doctors to take a more holistic view of people with AIDS, possibly by focusing less on their infection and more on their general health. Both suggest shifting the care for these patients towards primary care, in which people with AIDS would benefit from standard practices, such as advice about quitting smoking and other drugs, cancer screening, and chronic disease management for hypertension and diabetes.

In the five years of this study, annual mortality in people with AIDS fell faster for deaths related to HIV than for deaths from other causes, but a low CD4 count was an effective predictor for both. Injecting drug users had higher mortality than gay men.

Modern management of pre-eclampsia seems safer for babies

Many pregnancies complicated by pre-eclampsia now end in deliberate preterm delivery of the infant. Delivery cures the pre-eclampsia and may prevent a stillbirth, but it exposes the infant to all the risks of being born too early. Has the trend towards earlier intervention saved babies, or simply shifted their deaths from the womb to the postnatal period?

Observational data from Norway's almost complete register of births is encouraging. In a study of all first singleton births between 1967 and 2003, the risk of stillbirth fell …