Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania.
| Autor: | Chalamilla G; 1Harvard School of Public Health, Boston, MA, USA., Hawkins C, Okuma J, Spiegelman D, Aveika A, Christian B, Koda H, Kaaya S, Mtasiwa D, Fawzi W |
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| Jazyk: | angličtina |
| Zdroj: | Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002) [J Int Assoc Physicians AIDS Care (Chic)] 2012 Sep-Oct; Vol. 11 (5), pp. 296-304. Date of Electronic Publication: 2011 Jun 14. |
| DOI: | 10.1177/1545109711406733 |
| Abstrakt: | Objectives: Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS). Methods: Longitudinal analyses of clinical and immunologic parameters in HIV-infected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania. Results: A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm(3)). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256-490) and 427 (314-580) cells/mm(3), at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm(3), hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality. Conclusions: Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals. |
| Databáze: | MEDLINE |
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