Determinants of survival in AIDS patients on antiretroviral therapy in a rural centre in the Far-North Province, Cameroon
Determinants of survival in AIDS patients on antiretroviral therapy in a rural centre in the Far-North Province, Cameroon
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DOI：
10.1111/j.1365-3156.2008.02183.x
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发表时间：
2009-01-01
影响因子：
3.3
通讯作者：
Boelaert, Marleen
中科院分区：
文献类型：
--
作者：
Sieleunou, Isidore;Souleymanou, Mohamadou;Boelaert, Marleen
为了分析喀麦隆偏远省份一家乡村医院在常规条件下进行抗逆转录病毒疗法(ART)的效果，对2001年7月至2006年12月间开始抗逆转录病毒疗法的1187名患者进行了回顾队列研究。生存时间通过Kaplan-Meier分析和Cox比例风险模型进行拟合来解释生存。在登记时，90.4%的患者处于WHO III或IV期，56.1%的患者BMI<；18.5。CD4细胞计数中位数为105个/mm(3)(IQR40-173)。研究结束时，338/1187人死亡，59/1187人失访。1年生存率为77%[95%可信区间：75-80]，5年生存率为47%[95%可信区间：40-55]。中位生存期58个月。登记时的CD4计数、血红蛋白、体重指数、性别和临床阶段是死亡率的独立预测因素。这项研究证实了在偏远和资源受限的常规条件下开展抗逆转录病毒治疗计划的临床益处。未来的挑战是确保更早地获得抗逆转录病毒药物治疗，并保持其长期利益。
To analyse the outcomes of antiretroviral therapy (ART) in routine conditions in a rural hospital in the Far-North province of Cameroon.Retrospective cohort study of 1187 patients > 15 years who started ART between July 2001 and December 2006. The survival time was estimated by Kaplan-Meier analysis and Cox proportional hazard models were fitted to explain survival.Upon enrolment, 90.4% patients were in WHO stage III or IV and 56.1% had a BMI < 18.5. Median CD4 count was 105 cells/mm(3) (IQR 40-173). At the end of the study period, 338/1187 had died and 59/1187 were lost to follow-up. The survival probability was 77% at 1 year [95% CI: 75-80] and 47% at 5 years [95% CI: 40-55]. The median survival time was 58 months. CD4 count, haemoglobin, BMI, sex and clinical stage at enrolment were independent predictors of mortality.This study confirms the clinical benefit of ART programs in a remote and resource-constrained setting operating in routine conditions. The challenge ahead is to secure earlier access to ART and to maintain its longer-term benefit.