Year: 2005
Type: article
Study design: Observational Study
Abstract: Objectives.To describe the incidence, spectrum and prognosis of AIDS-defining illnesses (ADI) in patients without access to antiretroviral therapy (ART). Design. Prospective cohort study.Subjects. 1 215 HIV-infected patients attending adult HIV clinics affiliated to the University of Cape Town in the New Somerset and Groote Schuur Hospitals from 1992 to 2000. Main outcome measures. Incidence rate (IR) of ADIs and survival after the development of ADI.Results.During follow-up, 430 ADIs occurred (IR = 21.3 cases per 100 patient-years (PYs)).IR varied according to CD4 count, with 38.8, 17.0 and 8.52 cases/100 PYs in patients with CD4 counts < 200 cells/µl, 200 -350 cells/µl and > 350 cells/µl, respectively.Tuberculosis (TB) was the commonest ADI, followed by candidiasis of the oesophagus/trachea/bronchi.IRs for chronic herpes simplex ulcers, HIV wasting, Pneumocystis carinii pneumonia and Kaposi's sarcoma were > 1.00 cases/100 PYs.TB was diagnosed in all CD4 strata, and was the only illness to occur commonly above 200 cells/µl.The median CD4 counts within 6 months of diagnosis of ADI ranged from 138 cells/µl for TB to 17 cells/µl for cryptococcosis.Overall, median time to death from date of diagnosis was 18 months, and ranged from 24.1 months for patients diagnosed with TB to 6 months for those diagnosed with cytomegalovirus.Conclusions.HIV-infected patients with no access to ART in Cape Town are at high risk of AIDS-defining illnesses.This study provides useful data for designing therapeutic interventions for preventing these infections.HIV infection is characterised by progressive immune suppression, which eventually results in the development of opportunistic diseases.[1][2][3] The spectrum of these infections varies across the world, and is partially determined by the organisms that are prevalent in the community.
Institution: University of Cape Town
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $605
OpenAlex ID: W2286959065