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Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific
- Source :
- HIV Medicine. 21:397-402
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- Objectives Early mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource-limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with HIV (PLHIV) starting ART at low CD4 levels in the Asia-Pacific. Methods PLHIV enrolled in the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) who initiated ART with a CD4 count 1 year were censored at 12 months. Competing risk regression was used to analyse risk factors with loss to follow-up as a competing risk. Results A total of 1813 PLHIV were included in the study, of whom 74% were male. With 73 (4%) deaths, the overall first-year mortality rate was 4.27 per 100 person-years (PY). Thirty-eight deaths (52%) were AIDS-related, 10 (14%) were immune reconstituted inflammatory syndrome (IRIS)-related, 13 (18%) were non-AIDS-related and 12 (16%) had an unknown cause. Risk factors included having a body mass index (BMI) 100 cells/μL: SHR 0.12; 95% CI 0.05-0.26) was associated with reduced hazard for mortality compared to CD4 count ≤ 25 cells/μL. Conclusions Fifty-two per cent of early deaths were AIDS-related. Efforts to initiate ART at CD4 counts > 50 cell/μL are associated with improved short-term survival rates, even in those with late stages of HIV disease.
- Subjects :
- 0301 basic medicine
Observational database
medicine.medical_specialty
business.industry
Health Policy
Mortality rate
Human immunodeficiency virus (HIV)
medicine.disease
medicine.disease_cause
030112 virology
Antiretroviral therapy
03 medical and health sciences
0302 clinical medicine
Infectious Diseases
Asia pacific
Acquired immunodeficiency syndrome (AIDS)
Internal medicine
medicine
Pharmacology (medical)
030212 general & internal medicine
business
Late initiation
Body mass index
Subjects
Details
- ISSN :
- 14681293 and 14642662
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- HIV Medicine
- Accession number :
- edsair.doi...........cfe8d51a728a02f54d87a160139bb99e