Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013
| Autor: | Himanshu K. Chaturvedi, Laxmikant Chavan, Ram Bajpai, Nicole Seguy, Pauline Harvey, Lakshmanan Jayaseelan, Pinnamaneni Raj, Arvind Chandra Pandey |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
CD4-Positive T-Lymphocytes
Male Adult medicine.medical_specialty 030231 tropical medicine India lcsh:Medicine HIV Infections Kaplan-Meier Estimate Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Clinical endpoint medicine Risk of mortality Humans 030212 general & internal medicine Survival analysis Retrospective Studies business.industry Mortality rate lcsh:Public aspects of medicine Hazard ratio lcsh:R Public Health Environmental and Occupational Health CD4 lymphocyte count Retrospective cohort study lcsh:RA1-1270 Middle Aged Antiretroviral therapy R1 Confidence interval Acquired immunodeficiency syndrome Anti-Retroviral Agents Immunology Female Original Article business RA |
| Zdroj: | Journal of Preventive Medicine and Public Health, Vol 49, Iss 6, Pp 394-405 (2016) Journal of Preventive Medicine and Public Health |
| ISSN: | 2233-4521 |
| Popis: | Objectives\ud The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India.\ud \ud Methods\ud The present study used data from 139 679 HIV patients aged ≥15 years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival.\ud \ud Results\ud The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for 350 cells/mm3), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for 60 kg) were strongly associated with the survival of HIV patients.\ud \ud Conclusions\ud The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients. |
| Databáze: | OpenAIRE |
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