Advances in Infectious Diseases
Volume 3, Issue 4 (December 2013)
ISSN Print: 2164-2648 ISSN Online: 2164-2656
Google-based Impact Factor: 0.77 Citations
Mortality of HIV-Infected Patients on Antiretroviral Therapy in a Large Public Cohort in West Africa, Burkina Faso: Frequency and Associated Factors ()
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ABSTRACT
Background: In sub Saharan Africa, small size surveys have demonstrated early high mortality among infected patients on antiretroviral therapies (ART). Few studies have been conducted in large cohorts of HIV-patients in public health care system in West Africa. Objectives: Our study aims to determine mortality rate and its predictors in a cohort of patients on ART in a public daycare hospital in Burkina Faso. Methods: We have carried out a retrospective cohort study. All HIV-infected patients on ART between January 1st 2008 and December 31st 2011 were included in the study. Survival probability was estimated by the Kaplan-Meier method. Cox regression analysis was used to identify associated factors to mortality. Results: A total of 2243 HIV-infected patients were included in the study. During the follow-up, 218 patients representing 9.7% were lost. About 104 patients representing 4.6% were transferred and 1691 representing 75.4% were still in the therapeutic cohort. There were 230 death cases for a total of 4282 persons-years, (5.4 deaths for 100 persons-years; 95% CI: 4.8 -6.3). The survival probabilities after 6 months, 1 year and 2 years were 92.6%, 91% and 88.9% respectively. For the multivariate analysis, the following factors were independently associated to death: male gender, BMI < 18.5 kg/m2, WHO stage 3 and 4, HIV-2, T-CD4 lymphocytes < 200/μl, haemoglobin rate < 8 g/dl and creatinine clearance < 60 ml/m2. Conclusions: Our study provides for the first time mortality rates and its predictors among HIV-patients on antiretroviral treatment in a large cohort in public health sector in Burkina Faso. It highlights the importance of early HIV screening to limit ART initiation at advanced HIV infection stages.
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