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HIV Progression and Predictors of Mortality in a Community-Based Cohort of Zambian Adults
Maria Kitchen, MD, MSc*,
Maria A. Quigley, BA, MSc,
Alwyn M. Mwinga, MD, ChB, MMed, MSc,
Dietmar Fuchs, PhD,
Ida M. Lisse, MD,
John D. H. Porter, MD, MPH,
Keith P. W. J. McAdam, MB BChir, FRCP, FWACP,
and
Peter Godfrey-Faussett, BA, MBBS, FRCP
Medical University Innsbruck
* To whom correspondence should be addressed. E-mail: maria.kitchen{at}uki.at.
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Abstract |
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This article describes immunological HIV progression, mortality, and its predictors in 974 Zambian adults. During 3138 person-years of follow-up, 281 deaths occurred, and the overall mortality rate was 9.0 per 100 person-years. Thirty-six percent of patients were dead within 5 years of enrollment. The median survival in patients with baseline CD4 count 500 cells/mm3 was 5.62 years, with CD4 count between 200 and 499 cells/mm3 5.46 years, and with CD4 count 200 cells/mm3 3.89 years. The mortality rate increased significantly with older age (6.9 in patients 25 years, 9.3 in individuals aged 25-39 years, 10.2 in patients and was higher in women (rate ratio 1.29). The median annual change of progression markers was –29.6 cells/mm3 for CD4 count, –3.0% for CD4 count percentage, 1.2 nmol/L for neopterin, –1.9 g/L for hemoglobin, and –70 cells/ mm3 for total lymphocyte count. Hemoglobin and neopterin were as accurate as CD4 count to predict mortality.
First published on November 7, 2007, doi:10.1177/1545109707303989
Journal of the International Association of Physicians in AIDS Care (JIAPAC) 2008;7:17.
A more recent version of this article appeared on February 1, 2008
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