Abstract
The aim of this study is to assess whether HIV-related illness and World Health Organization (WHO) clinical stage can be used to guide initiation of antiretroviral therapy (ART) in rural Rakai District, Uganda. A retrospective cohort analysis of 910 HIV-seroprevalent individuals randomly sampled from a community cohort was conducted. The associations between HIV-related clinical illness and HIV viral loads >55,000 copies/mL and death were evaluated as a guide for initiation of ART. Reporting one or more HIV-related illnesses was associated with high specificity for identifying HIV viral load >55,000 copies/mL and predicting death within 30 months. There were more deaths in those with one symptom at baseline (16.3%) and two or more symptoms (25.0%) than in those reporting no symptoms (9.6%; P=0.001). HIV-related illness and WHO stage predicted disease progression. The specificity of clinical illness to predict viral load >55,000 copies/mL was high and could be used to rule in HIV disease requiring ART.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 116-120 |
| Number of pages | 5 |
| Journal | International Journal of STD and AIDS |
| Volume | 17 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2006 |
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Keywords
- AIDS care
- Algorithms
- Antiretroviral therapy
- Resource-limited setting
- Uganda
ASJC Scopus subject areas
- Dermatology
- Public Health, Environmental and Occupational Health
- Microbiology (medical)
- Immunology
Cite this
Clinical illness as a marker for initiation of HIV antiretroviral therapy in a rural setting, Rakai, Uganda. / Spacek, Lisa A.; Gray, Ronald H; Wawer, Maria J; Sewankambo, Nelson K.; Serwadda, David; Wabwire-Mangen, Fred; Kiwanuka, Noah; Kigozi, Godfrey; Nalugoda, Fred; Quinn, Thomas C.
In: International Journal of STD and AIDS, Vol. 17, No. 2, 02.2006, p. 116-120.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical illness as a marker for initiation of HIV antiretroviral therapy in a rural setting, Rakai, Uganda
AU - Spacek, Lisa A.
AU - Gray, Ronald H
AU - Wawer, Maria J
AU - Sewankambo, Nelson K.
AU - Serwadda, David
AU - Wabwire-Mangen, Fred
AU - Kiwanuka, Noah
AU - Kigozi, Godfrey
AU - Nalugoda, Fred
AU - Quinn, Thomas C
PY - 2006/2
Y1 - 2006/2
N2 - The aim of this study is to assess whether HIV-related illness and World Health Organization (WHO) clinical stage can be used to guide initiation of antiretroviral therapy (ART) in rural Rakai District, Uganda. A retrospective cohort analysis of 910 HIV-seroprevalent individuals randomly sampled from a community cohort was conducted. The associations between HIV-related clinical illness and HIV viral loads >55,000 copies/mL and death were evaluated as a guide for initiation of ART. Reporting one or more HIV-related illnesses was associated with high specificity for identifying HIV viral load >55,000 copies/mL and predicting death within 30 months. There were more deaths in those with one symptom at baseline (16.3%) and two or more symptoms (25.0%) than in those reporting no symptoms (9.6%; P=0.001). HIV-related illness and WHO stage predicted disease progression. The specificity of clinical illness to predict viral load >55,000 copies/mL was high and could be used to rule in HIV disease requiring ART.
AB - The aim of this study is to assess whether HIV-related illness and World Health Organization (WHO) clinical stage can be used to guide initiation of antiretroviral therapy (ART) in rural Rakai District, Uganda. A retrospective cohort analysis of 910 HIV-seroprevalent individuals randomly sampled from a community cohort was conducted. The associations between HIV-related clinical illness and HIV viral loads >55,000 copies/mL and death were evaluated as a guide for initiation of ART. Reporting one or more HIV-related illnesses was associated with high specificity for identifying HIV viral load >55,000 copies/mL and predicting death within 30 months. There were more deaths in those with one symptom at baseline (16.3%) and two or more symptoms (25.0%) than in those reporting no symptoms (9.6%; P=0.001). HIV-related illness and WHO stage predicted disease progression. The specificity of clinical illness to predict viral load >55,000 copies/mL was high and could be used to rule in HIV disease requiring ART.
KW - AIDS care
KW - Algorithms
KW - Antiretroviral therapy
KW - Resource-limited setting
KW - Uganda
UR - http://www.scopus.com/inward/record.url?scp=33644560597&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33644560597&partnerID=8YFLogxK
U2 - 10.1258/095646206775455766
DO - 10.1258/095646206775455766
M3 - Article
C2 - 16464274
AN - SCOPUS:33644560597
VL - 17
SP - 116
EP - 120
JO - International Journal of STD and AIDS
JF - International Journal of STD and AIDS
SN - 0956-4624
IS - 2
ER -