Survival and causes of death among HIV-infected patients starting antiretroviral therapy in north-eastern Vietnam

Duy, Cuong; Thorson, Anna; Sönnerborg, Anders; Hoa, Nguyen Phuong; Chúc, Nguyễn Thị Kim; Phuc, Ho Dang; Larsson, Mattias

doi:10.3109/00365548.2011.631937

Cited by 39 publications

(43 citation statements)

References 33 publications

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“…Low CD4+ T-cell counts and high baseline HIV RNA loads were not predictive of short-term mortality in our study. This finding differs from previous reports (4,5), possibly because many of the patients enrolled in our study were at more advanced stages of HIV disease upon admission. Therefore, challenges have arisen for the systematic management of critically ill HIV patients.…”

Section: Discussioncontrasting

confidence: 99%

“…The most important finding was that active TB accounted for 40.0% of short-term fatalities, which was similar to findings in Vietnam and Eastern Europe (4,11). Patients can be infected by TB regardless of their CD4+ T-cell count, but the risk for infection increases with the severity of immunodeficiency.…”

Section: Discussionsupporting

confidence: 75%

“…The higher mortality rate in our study is due to our patients' lower CD 4+ T-cell counts and more advanced clinical stages. AIDSrelated deaths still accounted for 80.0% of all deaths that occurred within the first six months of admission, which was identical to findings in Vietnam (4). In addition to TB, PCP was another important pre-ART cause of death.…”

Section: Discussionsupporting

confidence: 75%

“…In our study, 21.3% of patients died during the first six months of admission, which is higher than similar shortterm mortality rates in other studies (4,16). The higher mortality rate in our study is due to our patients' lower CD 4+ T-cell counts and more advanced clinical stages.…”

Section: Discussioncontrasting

confidence: 49%

“…In sub-Saharan Africa, leading causes of early death appear to include tuberculosis (TB), acute sepsis, cryptococcal meningitis, malignancy, and wasting syndrome (3). Some papers reported that the serum albumin level, baseline CD4+ T-cell count, HIV RNA load, WHO-defined clinical stage, and hemoglobin (HB) level were strongly predictive of mortality within one year (4)(5)(6)(7)(8). Active TB among HIV-infected patients, even if successfully treated, seems to increase the number of deaths (9).…”

Section: Introductionmentioning

confidence: 99%

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Baseline Factors Associated with Mortality within Six Months after Admission among Hospitalized HIV-1 Patients in Shenyang, China

et al. 2014

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Objective Short-term mortality rates remain high among critically ill human immunodeficiency virus-1 (HIV-1) patients though long-term mortality rates have dropped. Baseline risk factors for short-term mortality have not yet been determined in China. In this paper, we herein describe clinical characteristics, laboratory findings, causes of clinical deterioration, and risk factors associated with mortality among HIV-1 patients within six months after hospital admission. Methods We carried out a prospective study of hospitalized patients in advanced stages of HIV infection. These patients started antiretroviral therapy three or four weeks after admission. Follow-up was conducted for a period of six months. We used a multivariate logistic-regression analysis to identify risk factors associated with mortality. Results A total of 141 patients met our inclusion criteria. The mean age was 41 years. Fever and weight loss were the most common clinical manifestations of advanced HIV disease. Oral candidiasis, tuberculosis, cytomegaloviremia, and pneumocystis pneumonia were the most common opportunistic infections. Significantly decreased CD4+ T-cell counts, hypoalbuminemia, anemia, hyponatremia, as well as elevated C-reactive protein (CRP) and glutamic alanine transaminase levels were common laboratory test abnormalities. The mortality rate was 21.3%. The patients who died were more likely than the survivors to have low CD4+ Tcell counts as well as low creatinine, hemoglobin, albumin, and serum sodium levels while also having longer intervals of fever and higher CRP levels. A multivariate analysis demonstrated that the independent risk factors for mortality were active tuberculosis [odds ratio (OR): 2.681; 95% confidence interval (CI), p=0.049], hyponatremia (OR: 3.027; 95% CI, p=0.015), and being at clinical stage 4 (as defined by the World Health Organization) (OR: 9.492; 95% CI, 1.200-75.065; p=0.033) within the first six months of admission. Conclusion Special consideration should be given to patients who have active tuberculosis, are at clinical stage 4, and present with hyponatremia upon admission as these were found to be important factors associated with mortality within six months of hospital admission in HIV-1 patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

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Baseline Factors Associated with Mortality within Six Months after Admission among Hospitalized HIV-1 Patients in Shenyang, China

et al. 2014

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HIV Patients' Preference for Integrated Models of Addiction and HIV Treatment in Vietnam

Bich

Korthuis

Thu

et al. 2016

Journal of Substance Abuse Treatment

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Background Integrated care models for HIV and substance use disorders (SUD) care are proposed as a strategy for closing gaps in the HIV care continuum and reaching decreasing HIV transmission. We examined attitudes regarding integration of HIV and SUD treatment among HIV-infected patients with illicit drug and unhealthy alcohol use. Method We conducted a cross-sectional survey of HIV-infected patients receiving care at 5 HIV clinics in Hanoi, Vietnam, regarding substance use and attitudes toward HIV and SUD treatment integration. We used multivariate logistic regression to identify correlates of integrated care preference. Result Among 312 participants with current or past illicit drug use or unhealthy alcohol use, 81.4% preferred integrated treatment for HIV and SUD. In multivariate analysis, completing a college education (aOR 0.22, 95% CI 0.08, 0.65), risk of depression (aOR 3.51, 95% CI 1.57, 7.87), ever having received medication-assisted treatment for opioid use disorder (aOR 4.20, 95% CI 1.65, 10.69), being comfortable discussing substance use with counselors/nurses (aOR 3.86, 95% CI 1.38, 10.81) and having discussed alcohol use with their health providers (aOR 2.34, 95% CI 1.09, 4.99) were associated with patients’ preference for integrated care, after adjusting for age and gender. Conclusion Most, but not all, HIV-infected patients with substance use preferred integrated HIV and SUD treatment. Our findings suggest that policies to expand integration of HIV and SUD treatment will be well received by most patients, and that stand-alone treatment options should be preserved for a significant minority.

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Survival of people living with HIV after treatment with Traditional Chinese Medicine in Henan province of China: a retrospective cohort study

Jin

Liu

Chen

et al. 2014

Journal of Traditional Chinese Medicine

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Survival and causes of death among HIV-infected patients starting antiretroviral therapy in north-eastern Vietnam

Cited by 39 publications

References 33 publications

Baseline Factors Associated with Mortality within Six Months after Admission among Hospitalized HIV-1 Patients in Shenyang, China

Baseline Factors Associated with Mortality within Six Months after Admission among Hospitalized HIV-1 Patients in Shenyang, China

HIV Patients' Preference for Integrated Models of Addiction and HIV Treatment in Vietnam

Survival of people living with HIV after treatment with Traditional Chinese Medicine in Henan province of China: a retrospective cohort study

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