Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania

Guerino Chalamilla, Claudia Hawkins, James Okuma, Donna Spiegelman, Akum Aveika, Beatrice Christian, Happiness Koda, Sylvia Kaaya, Deo Mtasiwa, Wafaie Fawzi

Research output: Contribution to journalArticle

Abstract

Objectives: Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS). Methods: Longitudinal analyses of clinical and immunologic parameters in HIVinfected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania. Results: A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm3). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256-490) and 427 (314-580) cells/mm3, at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm3, hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality. Conclusions: Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals.

Original languageEnglish (US)
Pages (from-to)296-304
Number of pages9
JournalJournal of the International Association of Physicians in AIDS Care
Volume11
Issue number5
DOIs
StatePublished - Sep 1 2012
Externally publishedYes

Keywords

  • Tanzania
  • antiretroviral treatment
  • outcomes

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania'. Together they form a unique fingerprint.

  • Cite this

    Chalamilla, G., Hawkins, C., Okuma, J., Spiegelman, D., Aveika, A., Christian, B., Koda, H., Kaaya, S., Mtasiwa, D., & Fawzi, W. (2012). Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania. Journal of the International Association of Physicians in AIDS Care, 11(5), 296-304. https://doi.org/10.1177/1545109711406733