| Determinants of early and late mortality among HIV-infected individuals receiving home-based antiretroviral therapy in rural Uganda. | |
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MedLine Citation:
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PMID: 21857358 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: Up to 20% of people initiating antiretroviral therapy (ART) in sub- Saharan Africa die during the first year of treatment. Understanding the clinical conditions associated with mortality could potentially lead to effective interventions to prevent these deaths. METHODS:: We examined data from participants aged ≥18 years in the Home-Based AIDS Care project in Tororo, Uganda, to describe mortality over time and to determine clinical conditions associated with death. Survival analysis was used to examine variables associated with mortality at baseline and during follow-up. RESULTS:: A total of 112 (9.4%) deaths occurred in 1,132 subjects (73% women) during a median of 3.0 years of ART. Mortality was 15.9 per 100 person-years (PYR) during the first 3 months and declined to 0.3 per 100 PYR beyond 24 months after ART initiation. Tuberculosis (TB) was the most common condition associated with death (21% of deaths), followed by Candida disease (15%). In 43% of deaths no specific clinical diagnosis was identified. Deaths within 3 months after ART initiation were associated with WHO clinical stage III or IV at baseline, diagnosis of TB at baseline, a diagnosis of a non-TB opportunistic infection (OI) in follow-up and a body mass index (BMI) ≤ 17 kg/m during follow-up. Mortality after 3 months of ART was associated with CD4 cell counts <200 cells/μL, a diagnosis of TB or other OI, adherence to therapy <95%, and low hemoglobin levels during follow-up. CONCLUSION:: Potentially remediable conditions and preventable infections were associated with mortality while receiving ART in Uganda. |
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Authors:
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David M Moore; Constantin T Yiannoutsos; Beverly S Musick; Jordan Tappero; Richard Degerman; James Campbell; Willy Were; Frank Kaharuza; Lorraine N Alexander; Robert Downing; Jonathan Mermin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-18 |
Journal Detail:
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Title: Journal of acquired immune deficiency syndromes (1999) Volume: - ISSN: 1944-7884 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100892005 Medline TA: J Acquir Immune Defic Syndr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Global AIDS Program, US Centers for Disease Control and Prevention (CDC), Entebbe, Uganda.2 British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; 3 Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.; 4 Division of Biostatistics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.; 5 Division of HIV/AIDS Prevention, US CDC, Entebbe, Uganda.; 6 CDC-Kenya, Coordinating Office for Global Health, US CDC, Nairobi, Kenya. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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