TY - JOUR
T1 - Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania
AU - Chalamilla, Guerino
AU - Hawkins, Claudia
AU - Okuma, James
AU - Spiegelman, Donna
AU - Aveika, Akum
AU - Christian, Beatrice
AU - Koda, Happiness
AU - Kaaya, Sylvia
AU - Mtasiwa, Deo
AU - Fawzi, Wafaie
N1 - Funding Information:
We thank Management and Development for Health (MDH), Dar es Salaam City Council, Muhimbili University of Health and Allied Sciences (MUHAS), Harvard School of Public Health (HSPH), and the Ministry of Health and Social Welfare for the guidance and collaboration in implementing a national HIV care and treatment program in Dar es Salaam, Tanzania. This program is supported by the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the HSPH and by the Ministry of Health and Social Welfare, Tanzania. We thank all the patients and staff of the MDH supported care and treatment sites, who have contributed to these findings.
PY - 2012/9
Y1 - 2012/9
N2 - 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 HIVinfected 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/mm3). 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/mm3, 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/mm3, 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.
AB - 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 HIVinfected 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/mm3). 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/mm3, 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/mm3, 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.
KW - Tanzania
KW - antiretroviral treatment
KW - outcomes
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U2 - 10.1177/1545109711406733
DO - 10.1177/1545109711406733
M3 - Article
C2 - 21673195
AN - SCOPUS:84867013067
VL - 11
SP - 296
EP - 304
JO - Journal of the International Association of Physicians in AIDS Care
JF - Journal of the International Association of Physicians in AIDS Care
SN - 1545-1097
IS - 5
ER -
