OBJECTIVE: To provide estimates of survival and progression to different HIV disease endpoints after HIV infection among adults in a rural Ugandan setting. DESIGN: A prospective population-based cohort study. METHODS:Eligible individuals at least 15 years of age with documented HIV seroconversion were recruited from a general population cohort in rural Uganda, along with a randomly selected proportion of HIV-prevalent and HIV-negative individuals. All participants were followed up every 3 months, and CD4 cell counts taken every 6 months in HIV-positive participants. Life tables and Kaplan-Meier functions were used to estimate survival patterns for all endpoints [death, time to World Health Organization (WHO) stage 2, 3, AIDS and CD4 cell count < 200 cells/mul]. Analysis of follow-up time was truncated when antiretroviral therapy (ART) became available in the area in January 2004. RESULTS: We recruited 240 HIV incident cases, 108 prevalent cases and 257 HIV-negative controls. Crude mortality rates were 70.0 per 1000 person-years in HIV-positive, and 12.1 per 1000 person-years in HIV-negative individuals. The median time from seroconversion to death was 9.0 years (N = 240) and 6.2 years to a CD4 cell count less than 200 cells/mul or WHO stage 4 (N = 229). The median time from ART eligibility (CD4 cell count <; 200 cells/mul, < 350 cells/mul and WHO stage 3, or WHO stage 4) to death was 34.7 months. Older age at seroconversion was a risk factor for faster progression to death and ART eligibility. CONCLUSION: HIV progression in this African cohort is similar to that reported in industrialized countries before the widespread introduction of ART.
RCT Entities:
OBJECTIVE: To provide estimates of survival and progression to different HIV disease endpoints after HIV infection among adults in a rural Ugandan setting. DESIGN: A prospective population-based cohort study. METHODS: Eligible individuals at least 15 years of age with documented HIV seroconversion were recruited from a general population cohort in rural Uganda, along with a randomly selected proportion of HIV-prevalent and HIV-negative individuals. All participants were followed up every 3 months, and CD4 cell counts taken every 6 months in HIV-positive participants. Life tables and Kaplan-Meier functions were used to estimate survival patterns for all endpoints [death, time to World Health Organization (WHO) stage 2, 3, AIDS and CD4 cell count < 200 cells/mul]. Analysis of follow-up time was truncated when antiretroviral therapy (ART) became available in the area in January 2004. RESULTS: We recruited 240 HIV incident cases, 108 prevalent cases and 257 HIV-negative controls. Crude mortality rates were 70.0 per 1000 person-years in HIV-positive, and 12.1 per 1000 person-years in HIV-negative individuals. The median time from seroconversion to death was 9.0 years (N = 240) and 6.2 years to a CD4 cell count less than 200 cells/mul or WHO stage 4 (N = 229). The median time from ART eligibility (CD4 cell count < 200 cells/mul, < 350 cells/mul and WHO stage 3, or WHO stage 4) to death was 34.7 months. Older age at seroconversion was a risk factor for faster progression to death and ART eligibility. CONCLUSION: HIV progression in this African cohort is similar to that reported in industrialized countries before the widespread introduction of ART.
Authors: Gertrude Nakigozi; Fredrick E Makumbi; John B Bwanika; Lynn Atuyambe; Steven J Reynolds; Godfrey Kigozi; Fred Nalugoda; Larry W Chang; Valerian Kiggundu; David Serwadda; Maria J Wawer; Ronald H Gray; Moses R Kamya Journal: J Acquir Immune Defic Syndr Date: 2015-09-01 Impact factor: 3.731
Authors: Rebecca S Rudicell; James Holland Jones; Emily E Wroblewski; Gerald H Learn; Yingying Li; Joel D Robertson; Elizabeth Greengrass; Falk Grossmann; Shadrack Kamenya; Lilian Pintea; Deus C Mjungu; Elizabeth V Lonsdorf; Anna Mosser; Clarence Lehman; D Anthony Collins; Brandon F Keele; Jane Goodall; Beatrice H Hahn; Anne E Pusey; Michael L Wilson Journal: PLoS Pathog Date: 2010-09-23 Impact factor: 6.823
Authors: Milly Marston; Jim Todd; Judith R Glynn; Kenrad E Nelson; Ram Rangsin; Tom Lutalo; Mark Urassa; Sam Biraro; Lieve Van der Paal; Pam Sonnenberg; Basia Zaba Journal: AIDS Date: 2007-11 Impact factor: 4.177