Ten years of antiretroviral therapy: Incidences, patterns and risk factors of opportunistic infections in an urban Ugandan cohort
| Autor: | Barbara Castelnuovo, Dana Weissberg, Frank Mubiru, Andrew Kambugu, Christine Sekaggya-Wiltshire, Anna Baumann, Agnes N. Kiragga, Jan Fehr, Marisa B. Kaelin, Amrei von Braun, Moses R. Kamya |
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| Přispěvatelé: | University of Zurich |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Bacterial Diseases Viral Diseases Urban Population Epidemiology lcsh:Medicine 10234 Clinic for Infectious Diseases 0302 clinical medicine Risk Factors Infectious Diseases of the Nervous System Medicine and Health Sciences Uganda Public and Occupational Health 030212 general & internal medicine lcsh:Science Multidisciplinary Incidence (epidemiology) Incidence Candidiasis Viral Load Vaccination and Immunization Cryptococcal Meningitis Infectious Diseases Neurology Cohort Female Viral load medicine.drug Research Article Adult medicine.medical_specialty Nevirapine Tuberculosis Anemia Anti-HIV Agents Urology Immunology Sexually Transmitted Diseases Antiretroviral Therapy 610 Medicine & health 1100 General Agricultural and Biological Sciences Opportunistic Infections Microbiology Shingles 03 medical and health sciences Antiviral Therapy 1300 General Biochemistry Genetics and Molecular Biology Internal medicine Virology medicine Humans Retrospective Studies 1000 Multidisciplinary AIDS-Related Opportunistic Infections Proportional hazards model business.industry Genitourinary Infections lcsh:R Biology and Life Sciences Retrospective cohort study 10060 Epidemiology Biostatistics and Prevention Institute (EBPI) medicine.disease Tropical Diseases 030112 virology CD4 Lymphocyte Count Medical Risk Factors lcsh:Q Preventive Medicine business Viral Transmission and Infection Follow-Up Studies |
| Zdroj: | PLoS ONE PLoS ONE, Vol 13, Iss 11, p e0206796 (2018) |
| ISSN: | 1932-6203 |
| Popis: | Background Despite increased antiretroviral therapy (ART) coverage and the raised CD4 threshold for starting ART, opportunistic infections (OIs) are still one of the leading causes of death in sub-Saharan Africa. There are few studies from resource-limited settings on long-term reporting of OIs other than tuberculosis. Methods Patients starting ART between April 2004 and April 2005 were enrolled and followed-up for 10 years in Kampala, Uganda. We report incidences, patterns and risk factors using Cox proportional hazards models of OIs among all patients and among patients with CD4 cell counts >200 cells/μL. Results Of the 559 patients starting ART, 164 patients developed a total of 241 OIs during 10 years of follow-up. The overall incidence was highest for oral candidiasis (25.4, 95% confidence interval (CI): 20.5–31.6 per 1000 person-years of follow-up), followed by tuberculosis (15.3, 95% CI: 11.7–20.1), herpes zoster (12.3, 95% CI: 9.1–16.6) and cryptococcal meningitis (3.0, 95% CI: 1.7–5.5). Incidence rates for all OIs were highest in the first year after ART initiation and decreased with the increase of the current CD4 cell count. Factors independently associated with development of OIs were baseline nevirapine-based regimens, time-varying higher viral load, time-varying lower CD4 cell count and time-varying lower hemoglobin. In patients developing OIs at a current CD4 cell count >200 cells/μL, factors independently associated with OI development were time-varying increase in viral load and time-varying decrease in hemoglobin, whereas a baseline CD4 cell count |
| Databáze: | OpenAIRE |
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