Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania.

Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002) Pub Date : 2012-09-01 Epub Date: 2011-06-14 DOI:10.1177/1545109711406733

Guerino Chalamilla, Claudia Hawkins, James Okuma, Donna Spiegelman, Akum Aveika, Beatrice Christian, Happiness Koda, Sylvia Kaaya, Deo Mtasiwa, Wafaie Fawzi

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引用次数: 22

Abstract

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 HIV-infected 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/mm(3)). 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/mm(3), 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/mm(3), 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.

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坦桑尼亚达累斯萨拉姆艾滋病毒感染成人的死亡率和治疗失败。

目标:监测抗逆转录病毒治疗(ART)的结果对于评估资源有限环境下艾滋病毒护理和治疗方案的成功与否至关重要。方法:对2004年11月至2008年6月在卫生管理和发展(MDH)-总统艾滋病紧急救援计划-资助的坦桑尼亚艾滋病毒护理和治疗诊所接受抗逆转录病毒治疗的艾滋病毒感染成人的临床和免疫参数进行纵向分析。结果:共分析了12842例患者(65.9%为女性，中位基线CD4计数为106个细胞/mm(3))。免疫状态显著改善，CD4计数分别在1年、2年和3年增加到298(四分位数范围[IQR] 199-416)、372(256-490)和427(314-580)个细胞/毫米(3)。总死亡率为13.1%(12842例中1682例)。结论:在开始抗逆转录病毒治疗后，对男性和晚期艾滋病患者进行更密切的监测可能会改善这些个体的临床和免疫结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)

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