Impact of Hiv-associated conditions on mortality in people commencing anti-retroviral therapy in resource limited settings

摘要: Objectives To identify associations between specific WHO stage 3 and 4 conditions diagnosed after ART initiation all cause mortality for patients in resource-limited settings (RLS). Design, Setting Analysis of routine program data collected prospectively from 25 programs eight countries 2002 2010. Subjects, Participants 36,664 study participants with median follow-up 1.26 years (IQR 0.55–2.27). Outcome Measures Using a proportional hazards model we identified factors associated mortality, including the occurrence clinical during 6-months following initiation. Results There were 2922 deaths (8.0%). The crude rate was 5.41 per 100 person-years (95% CI: 5.21–5.61). diagnosis any or condition first 6 months increased (HR: 2.21; 95% 1.97–2.47). After adjustment age, sex, region pre-ART CD4 count, extrapulmonary cryptococcosis (aHR: 3.54; 2.74–4.56), HIV wasting syndrome 2.92; 95%CI: 2.21 -3.85), non-tuberculous mycobacterial infection 2.43; 1.80–3.28) Pneumocystis pneumonia 2.17; CI greatest mortality. Cerebral toxoplasmosis, pulmonary extra-pulmonary tuberculosis, Kaposi’s sarcoma oral oesophageal candidiasis though at lower rates. Conclusions A certain is an risk those initiating RLS. This information will assist initiatives to reduce excess prioritization resources diagnostics, therapeutic interventions research.