Survival after Long-Term ART Exposure: Findings from an Asian Patient Population Retained in Care beyond 5 Years on ART

Bijker, Rimke; Kiertiburanakul, Sasisopin; Kumarasamy, Nagalingeswaran; Pujari, Sanjay; Li-hua, Sun; Ng, Oon Tek; Lee, Man P; Choi, Jun Yong; Nguyen, Kinh Van; Chan, Yu Jiun; Merati, Tuti Parwati; Cuong, Do Duy; Ross, Jeremy; Jiamsakul, Awachana; Asia-Pacific, IeDEA

doi:10.3851/imp3358

Cited by 10 publications

(9 citation statements)

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“…In our study, hyperglycemia was associated with a more than 2-fold increase in mortality risk. Association between diabetes mellitus and death has been well documented [ 21 ], and our findings add to the body of knowledge showing that hyperglycemia is an independent risk factor for mortality [ 11 , 13 , 22 , 23 ]. Hyperglycemia can indicate missed diagnosis of diabetes mellitus, especially in resource-limited settings where care for non-communicable diseases is rarely integrated into HIV service delivery [ 24 ].…”

Section: Discussionsupporting

confidence: 78%

The prevalence of hyperglycemia and its impact on mortality among people living with HIV in Georgia

et al. 2022

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Background Life expectancy and quality of life of people living with HIV have been dramatically improved after introducing antiretroviral therapy, and the prevalence of non-communicable diseases has increased. Several studies have found that hyperglycemia with or without type 2 diabetes was associated with poor outcomes in people living with HIV. The study’s objective was to determine the prevalence of hyperglycemia and assess its impact on mortality. Materials and methods A retrospective cohort study was conducted among people living with HIV diagnosed in 2012–2018 and followed through 2020 at the Infectious Diseases, AIDS and Clinical Immunology Research Center in Tbilisi, Georgia. Primary outcomes of interest included the prevalence of hyperglycemia and mortality. Causes of death were classified according to the Coding of Death in HIV (CoDe) protocol. Results Our study included 2914 people living with HIV. Two hundred and forty-two (8.3%) patients had hyperglycemia, with an increasing prevalence by age. Three hundred one (9.7%) participants died over the median 3.71 (IQR: 2.14–5.37) years of follow-up. Among these, 139 (46.2%) were due to AIDS- related causes, 123 (40.9%)—were due to non-AIDS causes, and in 39 (12.9%) cases, the cause of death could not be determined. Overall, the cohort contributed to 11,148 person-years of follow-up (PYFU), translating into a mortality rate of 2.70 deaths per 100 PYFU. The mortality rate was significantly higher among individuals with hyperglycemia—11.17 deaths per 100 PYFU vs 2.07 deaths per 100 PYFU among normoglycemic patients(p<0.0001). Conclusions Hyperglycemia was associated with increased odds of mortality. Screening and management of hyperglycemia should be integrated into routine HIV clinical services as part of a comprehensive care package.

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Section: Discussionsupporting

confidence: 78%

The prevalence of hyperglycemia and its impact on mortality among people living with HIV in Georgia

et al. 2022

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“…Increasing age has been associated with increased mortality among PLHA in previously published studies also. (5)(6)(7) Various studies have shown male gender, lower CD4 counts at initiation of ART and ART regimens using didanosine or abacavir to be associated with unfavourable outcomes. (6-9) In the present study, gender, WHO stage at initiation of ART, CD4 count at initiation of ART, educational and occupational status, marital status, possible mode of HIV infection, delay from HIV diagnosis till ART initiation or the initial ART regimen were not predictive of mortality.…”

Section: Discussionmentioning

confidence: 99%

Survival of persons living with HIV/AIDS: A multicentric study from India

Sinha

Samad

Bansal

et al. 2022

Preprint

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Persons living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLHA) enrolled from antiretroviral therapy (ART) centers located in three different cities in India – Delhi, Pune and Kolkata, and were followed up at six monthly intervals monitoring the WHO stage, CD4 counts, complete blood counts and liver and kidney function tests, for a duration of three years. The incidence of mortality among HIV/AIDS patients on ART was 5·0 per 1000 patient years (21/1410, 1.4%). Age at initiation of ART being above 35 years was the only significant predictor of mortality (log rank p = 0·018). Multivariable analysis showed significant association of an unfavourable outcome (defined as mortality or development of opportunistic infection during follow-up) with male gender (adjusted odds ratio (AOR) = 5.26, p = < 0.01) and being unmarried at ART initiation (AOR = 1.39, p = 0.005). The survival of PLHA with good adherence to ART is independent of the WHO stage or CD4 counts at initiation of ART.

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“…A total of 441 adult HIV-positive individual records were reviewed with the median age (IQR) of the respondents was 32 (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) years. From the total study participants, more than half (59.86%) were females and nearly two-thirds, 62.36%, of the patients lived in urban areas.…”

Section: Socio-demographic Characteristics Of Patientsmentioning

confidence: 99%

Incidence of Mortality and Its Predictors Among Adult Human Immune Virus Infected Patients on Antiretroviral Therapy in Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: A Retrospective Follow-Up Study

Barata,

Abiso,

Israel

et al. 2023

HIV

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Background: Although the goal of ART is to have better health, extend the life of the HIV-infected patient, and decrease HIV-related death, there is a continuation of HIV-related mortality with the use of ART. This study aimed to assess the incidence of mortality and its predictors among adult HIV/AIDS patients who were on ART follow-up at Wolaita Sodo Comprehensive specialized hospital in southern Ethiopia. Methods: A retrospective follow-up study was conducted from May 1 to June 30, 2021 among adult HIV/AIDS patients with a total of 441 adult HIV/AIDS patients in this hospital included. Kaplan-Meier failure curve and Log rank test were fitted, and Coxproportional hazards model was also used to identify the predictors of mortality. Both crude and adjusted hazard ratios (AHR) with their 95% confidence interval (CI) were calculated to show the strength of association. The proportional assumption was conducted by using a global test based on the Schoenfeld residuals. Results: Incidence of the mortality rate was 5.61 (95% CI, 4.2-7.3) per 100 person-years observation. In the multivariable analysis, HIV/AIDS patients were widowed (aHR; 10.9 (95% CI, 3.13-37.99), poorly drug-adhered (aHR; 5.6 (95% CI, 2.4-13.2) and fair adhered (aHR; 3.53 (95% CI, 1.58-7.87), WHO clinical stage IV (aHR; 5.91, (95% CI, 1.41-24.71), history of substance use (aHR; 2.02 (95% CI, 1.01-4.06) and history of IV drug use (aHR; 2.26 (95% CI, 1.10-4.74) independently predicted the mortality of patients. Conclusion:In this study, incidence of mortality was relatively high. The rate of mortality may be minimized by paying particular attention to individuals with widowing, substance use at the baseline, advanced clinical stage IV, history of IV drug use at the baseline, and those with adherence problems.

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Survival after Long-Term ART Exposure: Findings from an Asian Patient Population Retained in Care beyond 5 Years on ART

Cited by 10 publications

References 50 publications

The prevalence of hyperglycemia and its impact on mortality among people living with HIV in Georgia

The prevalence of hyperglycemia and its impact on mortality among people living with HIV in Georgia

Survival of persons living with HIV/AIDS: A multicentric study from India

Incidence of Mortality and Its Predictors Among Adult Human Immune Virus Infected Patients on Antiretroviral Therapy in Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: A Retrospective Follow-Up Study

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