Estimated mortality of adult HIV-infected patients starting treatment with combination antiretroviral therapy.
Estimated mortality of adult HIV-infected patients starting treatment with combination antiretroviral therapy.
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DOI：
10.1136/sextrans-2012-050658
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发表时间：
2012-12
影响因子：
3.6
通讯作者：
International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration
中科院分区：
文献类型：
--
作者：
Yiannoutsos CT;Johnson LF;Boulle A;Musick BS;Gsponer T;Balestre E;Law M;Shepherd BE;Egger M;International Epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration
提供开始联合抗逆转录病毒治疗的艾滋病毒感染患者的死亡率估计。我们报告了来自东非、南非、西非、亚太地区和拉丁美洲的122名 925名年龄在15 或以上的成年艾滋病毒感染者的死亡率。我们使用两种方法来调整因失去随访而导致的死亡率估计偏差，这两种方法基于适用于患者外展(肯尼亚)和与生命登记(南非)联系的双抽样方法，并将这些方法应用于其他三个地区的死亡率估计。年龄、性别和治疗开始时的CD_4计数被认为是治疗开始后6、12、24和24 时死亡率的预测因素。在治疗后的头6个月内，所有患者亚组的患者死亡率都很高，在低 计数开始治疗的患者中，死亡率超过每百人年40人。无论地区、人口统计或与疾病相关的风险因素如何，都可以看到这一趋势。在比较被动监测患者生命状态所获得的估计时，死亡率被漏报了高达或超过100%。尽管在抗逆转录病毒治疗覆盖率方面取得了进展，但许多患者在开始治疗时的CD_4计数非常低，并且在治疗开始后的头6个 月内经历了显著的死亡率。积极的患者跟踪和与生命登记的联系在调整死亡率估计方面至关重要，特别是在低收入和中等收入环境中。
To provide estimates of mortality among HIV-infected patients starting combination antiretroviral therapy. We report on the death rates from 122 925 adult HIV-infected patients aged 15 years or older from East, Southern and West Africa, Asia Pacific and Latin America. We use two methods to adjust for biases in mortality estimation resulting from loss from follow-up, based on double-sampling methods applied to patient outreach (Kenya) and linkage with vital registries (South Africa), and apply these to mortality estimates in the other three regions. Age, gender and CD4 count at the initiation of therapy were the factors considered as predictors of mortality at 6, 12, 24 and >24 months after the start of treatment. Patient mortality was high during the first 6 months after therapy for all patient subgroups and exceeded 40 per 100 patient years among patients who started treatment at low CD4 count. This trend was seen regardless of region, demographic or disease-related risk factor. Mortality was under-reported by up to or exceeding 100% when comparing estimates obtained from passive monitoring of patient vital status. Despite advances in antiretroviral treatment coverage many patients start treatment at very low CD4 counts and experience significant mortality during the first 6 months after treatment initiation. Active patient tracing and linkage with vital registries are critical in adjusting estimates of mortality, particularly in low- and middle-income settings.
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影响因子：
3
作者：
Orlando, G.;Meraviglia, P.;Cargnel, A.
通讯作者：
Cargnel, A.
影响因子：
3.7
作者：
Brinkhof, Martin W. G.;Spycher, Ben D.;Sterne, Jonathan A. C.
通讯作者：
Sterne, Jonathan A. C.
DOI：
10.1097/qai.0b013e3181b843f0
发表时间：
2010-03
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Geng EH;Bangsberg DR;Musinguzi N;Emenyonu N;Bwana MB;Yiannoutsos CT;Glidden DV;Deeks SG;Martin JN
通讯作者：
Martin JN
影响因子：
1.4
作者：
Kumarasamy, N.;Venkatesh, K. K.;Ahilasamy, N.
通讯作者：
Ahilasamy, N.
影响因子：
3.7
作者：
Henriques J;Pujades-Rodriguez M;McGuire M;Szumilin E;Iwaz J;Etard JF;Ecochard R
通讯作者：
Ecochard R