Characteristics trends, mortality and morbidity in persons newly diagnosed HIV positive during the last decade: the profile of new HIV diagnosed people

Delpierre, Cyrille; Lauwers‐Cancès, Valérie; Puglièse, Pascal; Poizot‐Martin, Isabelle; Billaud, Éric; Duvivier, Claudine; Yazdanpanah, Yazdan

doi:10.1093/eurpub/ckm117

Cited by 29 publications

(26 citation statements)

References 10 publications

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“…We found an increased incidence of AIDS/death, particularly in the first year after HIV diagnosis [6],[18],[30]. There was also significant regional variation, with a 13-fold increased rate in persons in care in Southern Europe and a 6-fold increased rate in Eastern Europe.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)

et al. 2013

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“…22 However, lack of recognition may lead to delayed diagnosis, delayed treatment, and higher mortality. 23,24 Based on the multivariate analysis results, we identified three independent predictors, which were associated with mortality, including SBP 110 mmHg, PaO 2 at room air 60 mmHg, and lymphocytes 10%. The SBP reflected the presence of underlying medical comorbidities and general severity of illness, the PaO 2 level represented respiratory condition from PJP, and the percentage of lymphocyte was associated with the severity of underlying HIV disease.…”

Section: Predictors Of Mortalitymentioning

confidence: 99%

Mortality predictors of Pneumocystis jirovecii pneumonia in human immunodeficiency virus-infected patients at presentation: Experience in a tertiary care hospital of northern Taiwan

Wang

Lin

Kuo

et al. 2011

Journal of Microbiology, Immunology and Infection

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“…Despite recommendations of increasing CD4 thresholds for ART initiation, most people living with HIV in Tanzania still present late in the course of HIV disease. Late presentation is associated with higher prevalence of OIs and non-AIDS co-morbidities, incidence of immune reconstitution inflammatory syndrome (IRIS) after ART initiation, rate of hospitalisations, use of healthcare resources, and mortality [5–7]. Thus, pre-ART screening of OIs and co-morbidities is a key component to improving outcomes in sub-Saharan Africa.…”

Section: Introductionmentioning

confidence: 99%

A decade of HIV care in rural Tanzania: Trends in clinical outcomes and impact of clinic optimisation in an open, prospective cohort

et al. 2017

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ObjectivesOur objectives were to describe trends in enrolment and clinical outcomes in the open, prospective Kilombero and Ulanga Antiretroviral Cohort (KIULARCO) in the Morogoro region of southern Tanzania, and identify strengths and areas for improvement in the care of HIV-positive individuals in rural Tanzania.MethodsWe included adults (≥15 years) and children (<15 years) enrolled in the cohort in 2005–2014. The cohort underwent significant changes from autumn 2012 to optimise care. We evaluated mortality and loss to follow-up (LTFU) using competing risks methods, ART usage, opportunistic infections (OI), co-infections and laboratory abnormalities.ResultsOverall, 7010 adults and 680 children were enrolled; enrolment peaked in 2008 but has increased steadily since 2011. Among adults (65% female; median age 37 [interquartile range 31–45] years), the proportion referred from hospital wards quadrupled in 2013–14 versus earlier years. 653 (9%) adults died and 2648 (38%) were LTFU; the five-year cumulative probabilities of death and LTFU were 10.3% and 44.0%, respectively. Among children, 69 (10%) died and 225 (33%) were LTFU. The corresponding five-year probabilities were 12.1% and 39.6%. Adult ART use (regardless of eligibility) increased from 5% in 2005 to 89% in 2014 (similarly among children), with 9% on second-line therapy in 2014 (17% of children). OI diagnoses increased over time; tuberculosis prevalence at enrolment quadrupled from 6% in 2011 to 26% in 2014. The proportion of newly-enrolled participants assessed for laboratory abnormalities peaked at nearly 100% in 2014 (from a minimum of 24%), yet abnormality prevalences remained fairly constant.ConclusionsIn this cohort, ART usage improved dramatically and is approaching targets of 90%. Improved screening led to increases in detection of OIs and laboratory abnormalities, suggesting that a large number of these co-morbidities previously went undetected and untreated. Further work will address the high LTFU rates and implications for mortality estimates, and the management and outcomes of co-morbidities.

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Characteristics trends, mortality and morbidity in persons newly diagnosed HIV positive during the last decade: the profile of new HIV diagnosed people

Cited by 29 publications

References 10 publications

Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)

Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE)

Mortality predictors of Pneumocystis jirovecii pneumonia in human immunodeficiency virus-infected patients at presentation: Experience in a tertiary care hospital of northern Taiwan

A decade of HIV care in rural Tanzania: Trends in clinical outcomes and impact of clinic optimisation in an open, prospective cohort

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