Document Detail


Mortality, AIDS-morbidity, and loss to follow-up by current CD4 cell count among HIV-1-infected adults receiving antiretroviral therapy in Africa and Asia: data from the ANRS 12222 collaboration.
MedLine Citation:
PMID:  23274931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In resource-limited countries, estimating CD4-specific incidence rates of mortality and morbidity among patients receiving antiretroviral therapy (ART) may help assess the effectiveness of care and treatment programmes, identify program weaknesses, and inform decisions.
METHODS: We pooled data from 13 research cohorts in 5 sub-Saharan African (Benin, Burkina Faso, Cameroon, Cote d'Ivoire, and Senegal) and 2 Asian (Cambodia and Laos) countries. HIV-infected adults (18 years and older) who received ART in 1998-2008 and had at least one CD4 count available were eligible. Changes in CD4 counts over time were estimated by a linear mixed regression. CD4-specific incidence rates were estimated as the number of first events occurring in a given CD4 stratum divided by the time spent within the stratum.
RESULTS: Overall 3917 adults (62% women) on ART were followed up during 10,154 person-years. In the ≤ 50, 51-100, 101-200, 201-350, 351-500, 501-650, and >650 cells/mm CD4 cells strata, death rates were 20.6, 11.8, 6.7, 3.3, 1.8, 0.9, and 0.3 per 100 person-years; AIDS rates were 50.5, 32.9, 11.5, 4.8, 2.8, 2.2, and 2.2 per 100 person-years; and loss-to-follow-up rates were 4.9, 6.1, 3.5, 3.1, 2.9, 1.7, and 1.2 per 100 person-years, respectively. Mortality and morbidity were higher during the first year after ART initiation.
CONCLUSIONS: In these resource-limited settings, death and AIDS rates remained substantial after ART initiation, even in individuals with high CD4 cell counts. Ensuring earlier ART initiation and optimizing case finding and treatment for AIDS-defining diseases should be seen as priorities.
Authors:
Delphine Gabillard; Charlotte Lewden; Ibra Ndoye; Raoul Moh; Olivier Segeral; Besigin Tonwe-Gold; Jean-François Etard; Men Pagnaroat; Isabelle Fournier-Nicolle; Serge Eholié; Issouf Konate; Albert Minga; Eitel Mpoudi-Ngole; Sinata Koulla-Shiro; Djimon Marcel Zannou; Xavier Anglaret; Christian Laurent;
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  62     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-06-13     Completed Date:  2013-10-18     Revised Date:  2014-02-14    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-61     Citation Subset:  IM; X    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / drug therapy*,  mortality*,  virology
Adolescent
Adult
Africa South of the Sahara / epidemiology
Anti-HIV Agents / therapeutic use*
Asia / epidemiology
CD4 Lymphocyte Count
Cohort Studies
Female
HIV Infections / drug therapy*,  mortality*,  virology
HIV-1 / isolation & purification*
Humans
Incidence
Linear Models
Male
Young Adult
Grant Support
ID/Acronym/Agency:
R01 AI058736/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents
Investigator
Investigator/Affiliation:
Xavier Anglaret / ; Robert Colebunders / ; François Dabis / ; Joseph Drabo / ; Serge Eholié / ; Delphine Gabillard / ; Pierre-Marie Girard / ; Karine Lacombe / ; Christian Laurent / ; Vincent Le Moing / ; Charlotte Lewden / ; Gérard Allou / ; Clarisse Amani-Bossé / ; Divine Avit / ; Aida Benalycherif / ; Pierre de Beaudrap / ; Charlotte Boullé / ; Patrick Coffie / ; Ali Coulibaly / ; Eric Delaportee / ; Lise Denoeud / ; Serge Diagbouga / ; Didier Koumavi Ekouevi / ; Jean-François Etard / ; Sabrina Eymard-Duvernay / ; Patricia Fassinou / ; Isabelle Fournier-Nicolle / ; Hervé Hien / ; Charlotte Huet / ; Issouf Konate / ; Sinata Koulla-Shiro / ; Valériane Leroy / ; Olivier Marcy / ; Pierre Régis Martin / ; Nicolas Meda / ; Eugène Messou / ; Albert Minga / ; Eitel Mpoudi-Ngolé / ; Philippe Msellati / ; Boubacar Nacro / ; Nicolas Nagot / ; Ibra Ndoye / ; Thérèse N'Dri-Yoman / ; Abdoulaye Ouédraogo / ; Vara Ouk / ; Men Pagnaroat / ; Roger Salamon / ; Vonthanak Saphonn / ; Olivier Segeral / ; Catherine Seyler / ; Besigin Tonwe-Gold / ; Moussa Traore / ; Philippe Van de Perre / ; Ida Viho / ; Marcel Zannou /
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  High PMTCT program uptake and coverage of mothers, their partners and babies in Northern Uganda: Ach...
Next Document:  Direct quantification of cell-associated HIV DNA in isolated rectal and blood memory CD4 T cells rev...