ArticlePloS one2018
Ten years of antiretroviral therapy: Incidences, patterns and risk factors of opportunistic infections in an urban Ugandan cohort.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- A global overview of microsporidia infection in HIV/AIDS patients: an updated systematic review and meta-analysis.International health · 2026Pooled it
- Incidence and predictors of common opportunistic infections among children less than 15 years of age on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Pooled it
- Opportunistic infections among schoolchildren who were on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis.Frontiers in pediatrics · 2024Pooled it
- Outcomes and risk factors in HIV-positive patients with sepsis: a retrospective study.European journal of medical research · 2025Article
- Incidence and risk factors for tuberculosis at a rural HIV clinic in Uganda, 2012-2019; A retrospective cohort study.BMC public health · 2025Article
- Article
- Incidence and predictors of common opportunistic infections among children living with HIV at Bahir Dar City, Ethiopia.Scientific reports · 2024Article
- Opportunistic Infections in HIV-Infected Children on Treatment in Southern Morocco: A 12-Years Retrospective Follow-up Study.Infection & chemotherapy · 2024Article
- Increased Levels of Caspase-1 and IL-1β Among Adults With Persistent Immune Activation After 12 Years of Suppressive Antiretroviral Therapy in the Infectious Diseases Institute HIV Treatment Cohort.Open forum infectious diseases · 2023Article
- Magnitude of opportunistic infections and associated factors among adult people living with human immune deficient virus on art at selected public hospital, mogadishu somalia: cross-sectional study.Annals of medicine and surgery (2012) · 2023Article
- The Burden ofTropical medicine and infectious disease · 2023Review
- Cryptococcal meningitis among perinatally HIV-infected adolescents: Case series on presentation and management challenges.Clinical case reports · 2023Article
- Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study.Frontiers in pediatrics · 2023Article
- Prevalence and determinants of opportunistic infections among HIV-infected adults receiving antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.Frontiers in medicine · 2023Review
- Incidence and predictors of common opportunistic infection among HIV -infected children attending antiretroviral treatment clinic at Northeast Ethiopia, public hospitals 2022: A multicenter retrospective follow-up study.Annals of medicine and surgery (2012) · 2022Article
- Opportunistic Infections and Associated Factors among HIV-Infected Adult Persons on Antiretroviral Therapy at Ruhengeri Referral Hospital, Rwanda: A cross-sectional study.Rwanda journal of medicine and health sciences · 2022Article
- Late-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
- Longitudinal patients' cohorts for impactful research and HIV care at the Infectious Diseases Institute.African health sciences · 2022Article
- Low-frequency HIV-1 drug resistance mutations in antiretroviral naïve individuals in Botswana.Medicine · 2022Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite increased antiretroviral therapy (ART) coverage and the raised CD4 threshold for starting ART, opportunistic infections (OIs) are still one of the leading causes of death in sub-Saharan Africa. There are few studies from resource-limited settings on long-term reporting of OIs other than tuberculosis.
methodsPatients starting ART between April 2004 and April 2005 were enrolled and followed-up for 10 years in Kampala, Uganda. We report incidences, patterns and risk factors using Cox proportional hazards models of OIs among all patients and among patients with CD4 cell counts >200 cells/μL.
resultsOf the 559 patients starting ART, 164 patients developed a total of 241 OIs during 10 years of follow-up. The overall incidence was highest for oral candidiasis (25.4, 95% confidence interval (CI): 20.5-31.6 per 1000 person-years of follow-up), followed by tuberculosis (15.3, 95% CI: 11.7-20.1), herpes zoster (12.3, 95% CI: 9.1-16.6) and cryptococcal meningitis (3.0, 95% CI: 1.7-5.5). Incidence rates for all OIs were highest in the first year after ART initiation and decreased with the increase of the current CD4 cell count. Factors independently associated with development of OIs were baseline nevirapine-based regimens, time-varying higher viral load, time-varying lower CD4 cell count and time-varying lower hemoglobin. In patients developing OIs at a current CD4 cell count >200 cells/μL, factors independently associated with OI development were time-varying increase in viral load and time-varying decrease in hemoglobin, whereas a baseline CD4 cell count <50 cells/μL was protective.
conclusionWe report high early incidences of OIs, decreasing with increasing CD4 cell count and time spent on ART. Ongoing HIV replication and anemia were strong predictors for OI development independent of the CD4 cell count. Our findings support the recommendation for early initiation of ART and suggest close monitoring for OIs among patients recently started on ART, with low CD4 cell count, high viral load and anemia.
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