Details

Autor(en) / Beteiligte

• Marazzi, Maria Cristina
• Liotta, Giuseppe
• Germano, Paola
• Guidotti, Giovanni
• Altan, A Doro
• Ceffa, Susanna
• Lio, Massimo Magnano San
• Nielsen-Saines, Karin
• Palombi, Leonardo

Titel

Excessive early mortality in the first year of treatment in HIV type 1-infected patients initiating antiretroviral therapy in resource-limited settings

Ist Teil von

• AIDS research and human retroviruses, 2008-04, Vol.24 (4), p.555-560

Ort / Verlag

United States

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• The response to treatment and risk factors for early mortality following initiation of combination antiretrovirals(ARVs) in a cohort of African patients are described in a retrospective cohort design. Medical history, laboratory parameters, and mortality data were reviewed for patients initiating ARVs in 12 clinical centers in Mozambique, Tanzania, and Malawi. Among 3456 HIV-1-infected patients who received ARVs for more than 6 months, at baseline 72% had WHO clinical stages 3/4, 7% had a viral load 400 copies/ml, and 38% had a CD4 cell count >200/microl. One year later, 78% had undetectable virus loads and 79% had CD4 cell counts >200 cells/mm3. In the first year of HAART 260 deaths occurred (97 per 1000 person/years) with mortality peaking in the first 3 months. The highest mortality was observed in patients with low BMI, low hemoglobin levels, and CD4 values <200 cells/microl at baseline. Mortality rates following initiation of HAART are higher in patients in resource-limited areas, particularly in the first 90 days following treatment initiation.HAART initiated at higher CD4 cell count levels, especially among malnourished and/or anemic patients, will carry significant public health impact.