Mortality and its predictors among antiretroviral therapy naïve HIV-infected individuals with CD4 cell count ≥350 cells/mm3 compared to the general population: data from a population-based prospective HIV cohort in Uganda
| العنوان: | Mortality and its predictors among antiretroviral therapy naïve HIV-infected individuals with CD4 cell count ≥350 cells/mm3 compared to the general population: data from a population-based prospective HIV cohort in Uganda |
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| المؤلفون: | Masiira, Ben, Baisley, Kathy, Mayanja, Billy N., Kazooba, Patrick, Maher, Dermot, Kaleebu, Pontiano |
| المصدر: | Global Health Action, Vol 7, Iss 0, Pp 1-11 (2014) Global Health Action Global Health Action; Vol 7 (2014): incl Supplements |
| بيانات النشر: | Taylor & Francis Group, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Adult, Male, Adolescent, Epidemiology, Anti-HIV Agents, antiretroviral therapy naïve, HIV Infections, Kaplan-Meier Estimate, rural Uganda, general population, Young Adult, Risk Factors, Measuring HIV Associated Mortality in Africa, Humans, Uganda, Prospective Studies, mortality, HIV-infected, CD4 cell count ≥350 cells per mm3, lcsh:Public aspects of medicine, Age Factors, lcsh:RA1-1270, Middle Aged, CD4 Lymphocyte Count, Female |
| الوصف: | Background: Evidence exists that even at high CD4 counts, mortality among HIV-infected antiretroviral therapy (ART) naïve individuals is higher than that in the general population. However, many developing countries still initiate ART at CD4 ≤350 cells/mm3.Objective: To compare mortality among HIV-infected ART naïve individuals with CD4 counts ≥350 cells/mm3 with mortality in the general Ugandan population and to investigate risk factors for death.Design: Population-based prospective HIV cohort.Methods: The study population consisted of HIV-infected people in rural southwest Uganda. Patients were reviewed at the study clinic every 3 months. CD4 cell count was measured every 6 months. Rate ratios were estimated using Poisson regression. Indirect methods were used to calculate standardised mortality ratios (SMRs).Results: A total of 374 participants with CD4 ≥350 cells/mm3 were followed for 1,328 person-years (PY) over which 27 deaths occurred. Mortality rates (MRs) (per 1,000 PY) were 20.34 (95% CI: 13.95–29.66) among all participants and 16.43 (10.48–25.75) among participants aged 15–49 years. Mortality was higher in periods during which participants had CD4 350–499 cells/mm3 than during periods of CD4 ≥500 cells/mm3 although the difference was not statistically significant [adjusted rate ratio (aRR)=1.52; 95% CI: 0.71–3.25]. Compared to the general Ugandan population aged 15–49 years, MRs were 123% higher among participants with CD4 ≥500 cells/mm3 (SMR: 223%, 95% CI: 127–393%) and 146% higher among participants with CD4 350–499 cells/mm3 (246%, 117%–516). After adjusting for current age, mortality was associated with increasing WHO clinical stage (aRR comparing stage 3 or 4 and stage 1: 10.18, 95% CI: 3.82–27.15) and decreasing body mass index (BMI) (aRR comparing categories ≤17.4 Kg/m2 and ≥18.5 Kg/m2: 6.11, 2.30–16.20).Conclusion: HIV-infected ART naïve individuals with CD4 count ≥350 cells/mm3 had a higher mortality than the general population. After adjusting for age, the main predictors of mortality were WHO clinical stage and BMI. Keywords: mortality; HIV-infected; antiretroviral therapy naïve; general population; CD4 cell count ≥350 cells per mm3; rural Uganda(Published: 15 January 2014)Citation: Glob Health Action 2014, 7: 21843 - http://dx.doi.org/10.3402/gha.v7.21843SPECIALTest ISSUEThis paper is part of the Special Issue Measuring HIV Associated Mortality in Africa. More papers from this issue can be found here and here. |
| وصف الملف: | application/pdf; text/html; application/epub+zip; text/plain |
| اللغة: | English |
| تدمد: | 1654-9880 1654-9716 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::f18f607af865889873738ecf975b874fTest http://www.globalhealthaction.net/index.php/gha/article/view/21843Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.pmid.dedup....f18f607af865889873738ecf975b874f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16549880 16549716 |
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