Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies
2008

Duration from HIV Seroconversion to ART Eligibility and Death

Sample size: 2072 publication Evidence: moderate

Author Information

Author(s): Simon Wandel, Matthias Egger, Ram Rangsin, Kenrad E Nelson, Caroline Costello, Charlotte Lewden, Tom Lutalo, Anthony Ndyanabo, Jim Todd, Lieve Van der Paal, Albert Minga, Marcel Zwahlen

Primary Institution: Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland

Hypothesis

What is the duration from seroconversion to ART eligibility and from ART eligibility to death in HIV-infected adults in low-income and middle-income countries?

Conclusion

The duration from different ART eligibility criteria to death was found to be longer than previously estimated.

Supporting Evidence

  • The median duration from seroconversion to ART eligibility was 6.1 years.
  • The mean time from CD4 T-lymphocyte count <200 cells ×106/l to death was estimated at 3.9 years.
  • 794 participants died during the study, most while not on ART.
  • 66% of the total survival time occurred after becoming eligible for ART.

Takeaway

This study looked at how long it takes for people with HIV to start treatment and how long they live after that. It found that people wait longer to get treatment than we thought.

Methodology

We used Weibull survival models and Bayesian simulation methods to analyze data from five cohorts of HIV-infected adults.

Potential Biases

Heterogeneity across cohorts may introduce bias in the estimates.

Limitations

The number of included cohorts was small, and information on treatment eligibility was limited for some cohorts.

Participant Demographics

Participants were HIV-infected adults from low-income and middle-income countries, with a mix of genders and ages.

Statistical Information

Confidence Interval

95% credibility interval

Digital Object Identifier (DOI)

10.1136/sti.2008.029793

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