HIV-1 disease progression and mortality before the introduction of highly active antiretroviral therapy in rural Uganda.


Van der Paal, L; Shafer, LA; Todd, J; Mayanja, BN; Whitworth, JA; Grosskurth, H; (2007) HIV-1 disease progression and mortality before the introduction of highly active antiretroviral therapy in rural Uganda. AIDS (London, England), 21 Suppl 6. S21-9. ISSN 0269-9370 DOI: https://doi.org/10.1097/01.aids.0000299407.52399.05

Full text not available from this repository. (Request a copy)

Abstract

OBJECTIVE: To provide estimates of survival and progression to different HIV disease endpoints after HIV infection among adults in a rural Ugandan setting. DESIGN: A prospective population-based cohort study. METHODS: Eligible individuals at least 15 years of age with documented HIV seroconversion were recruited from a general population cohort in rural Uganda, along with a randomly selected proportion of HIV-prevalent and HIV-negative individuals. All participants were followed up every 3 months, and CD4 cell counts taken every 6 months in HIV-positive participants. Life tables and Kaplan-Meier functions were used to estimate survival patterns for all endpoints [death, time to World Health Organization (WHO) stage 2, 3, AIDS and CD4 cell count < 200 cells/mul]. Analysis of follow-up time was truncated when antiretroviral therapy (ART) became available in the area in January 2004. RESULTS: We recruited 240 HIV incident cases, 108 prevalent cases and 257 HIV-negative controls. Crude mortality rates were 70.0 per 1000 person-years in HIV-positive, and 12.1 per 1000 person-years in HIV-negative individuals. The median time from seroconversion to death was 9.0 years (N = 240) and 6.2 years to a CD4 cell count less than 200 cells/mul or WHO stage 4 (N = 229). The median time from ART eligibility (CD4 cell count < 200 cells/mul, < 350 cells/mul and WHO stage 3, or WHO stage 4) to death was 34.7 months. Older age at seroconversion was a risk factor for faster progression to death and ART eligibility. CONCLUSION: HIV progression in this African cohort is similar to that reported in industrialized countries before the widespread introduction of ART.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
Tropical Epidemiology Group
Population Studies Group
PubMed ID: 18032935
Web of Science ID: 251794200004
URI: http://researchonline.lshtm.ac.uk/id/eprint/2242

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
296Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item