Pre-treatment Mortality in HIV Patients in The Gambia
Author Information
Author(s): Toyin Togun, Ingrid Peterson, Shabbar Jaffar, Francis Oko, Uduak Okomo, Kevin Peterson, Assan Jaye
Primary Institution: Medical Research Council - The Gambia Unit
Hypothesis
What is the pre-treatment mortality rate and its predictors among ART-eligible adult patients in a West Africa clinic-based cohort?
Conclusion
A high proportion of ART-eligible patients did not start treatment, and the pre-treatment mortality rate was significant among HIV-infected patients in the cohort.
Supporting Evidence
- 64.6% of ART-eligible patients started treatment.
- 21.9 deaths per 100 person-years was the pre-treatment mortality rate.
- 40% of patients lost to follow-up cited difficulty with disclosing their HIV status as a reason for not starting ART.
Takeaway
Many people who could get HIV treatment didn't start it, and a lot of them died before they could. This shows that we need to help them get treatment faster.
Methodology
The study included all HIV-infected patients aged 15 years or older eligible for ART from June 2004 to September 2009, using Kaplan-Meier estimates and Cox proportional hazard models for analysis.
Potential Biases
Potential bias due to the requirement of disclosing HIV status before starting ART, which may deter patients from initiating treatment.
Limitations
The study may underestimate pre-treatment mortality due to patients lost to follow-up who could not be traced.
Participant Demographics
The median age was 37 years, with 68.2% female, and included 81.9% HIV-1, 13.0% HIV-2, and 5.1% dually infected patients.
Statistical Information
P-Value
<0.001
Confidence Interval
95% CI 18.3 - 26.2
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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