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Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study.
AIDS. 2006 May 12; 20(8):1181-9.AIDS

Abstract

OBJECTIVES

To evaluate survival and investigate causes of death among HIV-1 infected adults receiving HAART in Senegal.

DESIGN

An observational prospective cohort.

METHODS

Mortality was assessed in the first patients enrolled between August 1998 and April 2002 in the Senegalese antiretroviral drug access initiative. First-line regimen combined two nucleoside reverse transcriptase inhibitors and either a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor. The most likely causes of death were ascertained through medical records or post-mortem interviews (verbal autopsy).

RESULTS

Four hundred and four patients (54.7% women) were enrolled in the study and were followed for a median of 46 months (interquartile range: 32-57 months) after HAART initiation. At baseline, 5% were antiretroviral therapy (ART) non-naive, 39 and 55% were respectively at CDC stage B and C, median age, CD4 cell count and viral load were 37 years, 128 cells/microl and 5.2 log cp/ml, respectively. Ninety-three patients died during follow-up and the overall incidence rate of death was 6.3/100 person-years [95% confidence interval (CI), 5.2-7.7]. During the first year after HAART initiation, 47 patients died and seven were lost to follow-up, yielding to a probability of dying of 11.7% (95% CI, 8.9-15.3%). The death rate, which was highest during the first year after HAART initiation, decreased with time yielding a cumulative probability of dying of 17.4% (95% CI, 13.9-21.5%) and 24.6% (95% CI, 20.4-29.4%) at 2 and 5 years. Causes of death were ascertained in 76 deaths. Mycobacterial infections, neurotropic infections and septicaemia were the most frequent likely causes of death.

CONCLUSIONS

This study underlines the early mortality pattern after HAART initiation and highlights the leading role of mycobacterial infections in the causes of death.

Authors+Show Affiliations

UMR 145 HIV/AIDS and Associated Diseases, Research Institute for Development (IRD)/University of Montpellier, 911 avenue Agropolis, 34394 Montpellier Cedex 1, France. etard@mpl.ird.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16691070

Citation

Etard, Jean-François, et al. "Mortality and Causes of Death in Adults Receiving Highly Active Antiretroviral Therapy in Senegal: a 7-year Cohort Study." AIDS (London, England), vol. 20, no. 8, 2006, pp. 1181-9.
Etard JF, Ndiaye I, Thierry-Mieg M, et al. Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study. AIDS. 2006;20(8):1181-9.
Etard, J. F., Ndiaye, I., Thierry-Mieg, M., Guèye, N. F., Guèye, P. M., Lanièce, I., Dieng, A. B., Diouf, A., Laurent, C., Mboup, S., Sow, P. S., & Delaporte, E. (2006). Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study. AIDS (London, England), 20(8), 1181-9.
Etard JF, et al. Mortality and Causes of Death in Adults Receiving Highly Active Antiretroviral Therapy in Senegal: a 7-year Cohort Study. AIDS. 2006 May 12;20(8):1181-9. PubMed PMID: 16691070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality and causes of death in adults receiving highly active antiretroviral therapy in Senegal: a 7-year cohort study. AU - Etard,Jean-François, AU - Ndiaye,Ibrahima, AU - Thierry-Mieg,Marion, AU - Guèye,Ndèye Fatou Ngom, AU - Guèye,Pape Mandoumbé, AU - Lanièce,Isabelle, AU - Dieng,Allé Baba, AU - Diouf,Assane, AU - Laurent,Christian, AU - Mboup,Souleymane, AU - Sow,Papa Salif, AU - Delaporte,Eric, PY - 2006/5/13/pubmed PY - 2006/6/30/medline PY - 2006/5/13/entrez SP - 1181 EP - 9 JF - AIDS (London, England) JO - AIDS VL - 20 IS - 8 N2 - OBJECTIVES: To evaluate survival and investigate causes of death among HIV-1 infected adults receiving HAART in Senegal. DESIGN: An observational prospective cohort. METHODS: Mortality was assessed in the first patients enrolled between August 1998 and April 2002 in the Senegalese antiretroviral drug access initiative. First-line regimen combined two nucleoside reverse transcriptase inhibitors and either a non-nucleoside reverse transcriptase inhibitor or a protease inhibitor. The most likely causes of death were ascertained through medical records or post-mortem interviews (verbal autopsy). RESULTS: Four hundred and four patients (54.7% women) were enrolled in the study and were followed for a median of 46 months (interquartile range: 32-57 months) after HAART initiation. At baseline, 5% were antiretroviral therapy (ART) non-naive, 39 and 55% were respectively at CDC stage B and C, median age, CD4 cell count and viral load were 37 years, 128 cells/microl and 5.2 log cp/ml, respectively. Ninety-three patients died during follow-up and the overall incidence rate of death was 6.3/100 person-years [95% confidence interval (CI), 5.2-7.7]. During the first year after HAART initiation, 47 patients died and seven were lost to follow-up, yielding to a probability of dying of 11.7% (95% CI, 8.9-15.3%). The death rate, which was highest during the first year after HAART initiation, decreased with time yielding a cumulative probability of dying of 17.4% (95% CI, 13.9-21.5%) and 24.6% (95% CI, 20.4-29.4%) at 2 and 5 years. Causes of death were ascertained in 76 deaths. Mycobacterial infections, neurotropic infections and septicaemia were the most frequent likely causes of death. CONCLUSIONS: This study underlines the early mortality pattern after HAART initiation and highlights the leading role of mycobacterial infections in the causes of death. SN - 0269-9370 UR - https://www.unboundmedicine.com/medline/citation/16691070/Mortality_and_causes_of_death_in_adults_receiving_highly_active_antiretroviral_therapy_in_Senegal:_a_7_year_cohort_study_ L2 - https://doi.org/10.1097/01.aids.0000226959.87471.01 DB - PRIME DP - Unbound Medicine ER -