ArticlePloS one2013
The effect of a maturing antiretroviral program on early mortality for patients with advanced immune-suppression in Soweto, South Africa.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Peer-Led Community-Based Support Services and HIV Treatment Outcomes Among People Living With HIV in Wuxi, China: Propensity Score-Matched Analysis of Surveillance Data From 2006 to 2021.JMIR public health and surveillance · 2023Article
- Rutin Attenuates Hepatotoxicity in High-Cholesterol-Diet-Fed Rats.Oxidative medicine and cellular longevity · 2016Article
- Factors associated with mortality in HIV-infected people in rural and urban South Africa.Global health action · 2014Article
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Authors and funding
5 authors.
Funding
Abstract
objectiveWe hypothesize that time to initiate care and maturity of a treatment program impact on outcome of severely immuno-compromised patients with higher risk of mortality.
designWe conducted a retrospective cohort analysis at the Perinatal HIV Research Unit Adult ART clinic, Soweto, South Africa.
methodsELIGIBILITY CRITERIA FOR THIS ANALYSIS WERE: attendance for minimum one visit between August 2004 and August 2010, age >18 years, CD4 count < 50 cells/mm(3) and ART-naïve at screening. We followed participants up to one year after ART initiation. We defined years 2004-2007 and 2008-2010 as the early and late eras respectively. Chi-square test and survival analysis methods were used for mortality comparisons between eras.
resultsOf 2357 patients eligible for antiretroviral treatment, 395 (17%) had CD4 counts < 50 cells/mm(3) and ART-naïve at screening. Overall 261 (66%) were women. Patients had similar median age (35 vs. 33.5 years, p=0.08), time to HAART initiation (7 days, p=0.18) and baseline CD4 count (20 vs. 23 cells/mm(3), p=0.5) between eras. Overall 63 (16%) patients died in their first year of treatment (2 per 100 person-months) and the main cause of death was tuberculosis (n=23, 37%). The proportion of deaths (52/262 vs. 11/133, p=0.003) and time to death from enrolment (logrank p=0.04) were significantly different between eras.
conclusionMortality decreased as the ART program matured in Soweto while time to initiation of treatment remained similar in both eras. Because ART guidelines were consistent during both eras, it is possible that with time, management of patients improved as expertise was gained.
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