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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Predictors of mortality in patients initiating antiretroviral therapy in Durban, South Africa</title><author><name sortKey="Ojikutu, Bisola O" sort="Ojikutu, Bisola O" uniqKey="Ojikutu B" first="Bisola O" last="Ojikutu">Bisola O. Ojikutu</name></author><author><name sortKey="Zheng, Hui" sort="Zheng, Hui" uniqKey="Zheng H" first="Hui" last="Zheng">Hui Zheng</name></author><author><name sortKey="Walensky, Rochelle P" sort="Walensky, Rochelle P" uniqKey="Walensky R" first="Rochelle P" last="Walensky">Rochelle P. Walensky</name></author><author><name sortKey="Lu, Zhigang" sort="Lu, Zhigang" uniqKey="Lu Z" first="Zhigang" last="Lu">Zhigang Lu</name></author><author><name sortKey="Losina, Elena" sort="Losina, Elena" uniqKey="Losina E" first="Elena" last="Losina">Elena Losina</name></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name></author><author><name sortKey="Freedberg, Kenneth A" sort="Freedberg, Kenneth A" uniqKey="Freedberg K" first="Kenneth A" last="Freedberg">Kenneth A. Freedberg</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18350223</idno><idno type="pmc">2408889</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2408889</idno><idno type="RBID">PMC:2408889</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000F77</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F77</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Predictors of mortality in patients initiating antiretroviral therapy in Durban, South Africa</title><author><name sortKey="Ojikutu, Bisola O" sort="Ojikutu, Bisola O" uniqKey="Ojikutu B" first="Bisola O" last="Ojikutu">Bisola O. Ojikutu</name></author><author><name sortKey="Zheng, Hui" sort="Zheng, Hui" uniqKey="Zheng H" first="Hui" last="Zheng">Hui Zheng</name></author><author><name sortKey="Walensky, Rochelle P" sort="Walensky, Rochelle P" uniqKey="Walensky R" first="Rochelle P" last="Walensky">Rochelle P. Walensky</name></author><author><name sortKey="Lu, Zhigang" sort="Lu, Zhigang" uniqKey="Lu Z" first="Zhigang" last="Lu">Zhigang Lu</name></author><author><name sortKey="Losina, Elena" sort="Losina, Elena" uniqKey="Losina E" first="Elena" last="Losina">Elena Losina</name></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name></author><author><name sortKey="Freedberg, Kenneth A" sort="Freedberg, Kenneth A" uniqKey="Freedberg K" first="Kenneth A" last="Freedberg">Kenneth A. Freedberg</name></author></analytic><series><title level="j">South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde</title><idno type="ISSN">0256-9574</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To identify predictors of mortality in patients initiating antiretroviral therapy (ART) in Durban, South Africa.</p></sec><sec id="S2"><title>Design</title><p id="P2">We conducted a retrospective cohort study analysing data on patients who presented to McCord Hospital, Durban, and started ART between 1 January 1999 and 29 February 2004. We performed univariate and multivariate analysis and constructed Kaplan-Meier curves to assess predictors.</p></sec><sec id="S3"><title>Results</title><p id="P3">Three hundred and nine patients were included. Forty-nine (16%) had died by the conclusion of the study. In univariate analysis, the strongest predictors of mortality were a CD4 cell count <50/μl (hazard ratio (HR) 3.70, 95% confidence interval (CI) 1.96 − 7.14), a haemoglobin concentration ≤8 g/dl (HR 1.23, 95% CI 1.08 − 1.40), a history of oral candidiasis (HR 3.17, 95% CI 1.70 − 5.87) and a history of cryptococcal meningitis (HR 2.76, 95% CI 1.80 − 19.2). A CD4 cell count <50/μl (HR 3.08, 95% CI 1.54 − 5.88) and a history of oral candidiasis (HR 2.58, 95% CI 1.37 − 4.88) remained significant in multivariate analysis. A history of tuberculosis was not a significant predictor of mortality.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Simple clinical and laboratory data independently predict mortality and allow for risk stratification in patients initiating ART in South Africa. Interventions enabling patients to be identified before they develop these clinical markers and earlier initiation of ART will help to ensure maximum benefits of therapy.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0404520</journal-id><journal-id journal-id-type="pubmed-jr-id">7363</journal-id><journal-id journal-id-type="nlm-ta">S Afr Med J</journal-id><journal-title>South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde</journal-title><issn pub-type="ppub">0256-9574</issn></journal-meta><article-meta><article-id pub-id-type="pmid">18350223</article-id><article-id pub-id-type="pmc">2408889</article-id><article-id pub-id-type="manuscript">NIHMS48991</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Predictors of mortality in patients initiating antiretroviral therapy in Durban, South Africa</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ojikutu</surname><given-names>Bisola O</given-names></name><degrees>MD, MPH</degrees><aff id="A1">Harvard Center for AIDS Research (CFAR) and Division of AIDS, Harvard Medical School, Boston, MA, USA, and Division of Infectious Disease, Massachusetts General Hospital, Harvard Medical School</aff></contrib><contrib contrib-type="author"><name><surname>Zheng</surname><given-names>Hui</given-names></name><degrees>PhD</degrees><aff id="A2">CFAR and Division of AIDS, Harvard Medical School</aff></contrib><contrib contrib-type="author"><name><surname>Walensky</surname><given-names>Rochelle P</given-names></name><degrees>MD, MPH</degrees><aff id="A3">CFAR and Division of AIDS, Harvard Medical School, and Divisions of General Medicine and Infectious Disease, Massachusetts General Hospital</aff></contrib><contrib contrib-type="author"><name><surname>Lu</surname><given-names>Zhigang</given-names></name><degrees>MD</degrees><aff id="A4">CFAR and Division of AIDS, Harvard Medical School, and Division of General Medicine, Massachusetts General Hospital</aff></contrib><contrib contrib-type="author"><name><surname>Losina</surname><given-names>Elena</given-names></name><degrees>PhD</degrees><aff id="A5">Department of Biostatistics, Boston University School of Public Health, Boston</aff></contrib><contrib contrib-type="author"><name><surname>Giddy</surname><given-names>Janet</given-names></name><degrees>MB, ChB</degrees><aff id="A6">McCord Hospital, Durban, South Africa</aff></contrib><contrib contrib-type="author"><name><surname>Freedberg</surname><given-names>Kenneth A</given-names></name><degrees>MD, MSc</degrees><aff id="A7">CFAR and Division of AIDS, Harvard Medical School, Divisions of General Medicine and Infectious Disease, Massachusetts General Hospital, and McCord Hospital</aff></contrib></contrib-group><author-notes><corresp id="CR1"><bold>Corresponding author:</bold> B Ojikutu (<email>bojikutu@partners.org</email>)</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>2</day><month>5</month><year>2008</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2008</year></pub-date><pub-date pub-type="pmc-release"><day>2</day><month>6</month><year>2008</year></pub-date><volume>98</volume><issue>3</issue><fpage>204</fpage><lpage>208</lpage><abstract><sec id="S1"><title>Objective</title><p id="P1">To identify predictors of mortality in patients initiating antiretroviral therapy (ART) in Durban, South Africa.</p></sec><sec id="S2"><title>Design</title><p id="P2">We conducted a retrospective cohort study analysing data on patients who presented to McCord Hospital, Durban, and started ART between 1 January 1999 and 29 February 2004. We performed univariate and multivariate analysis and constructed Kaplan-Meier curves to assess predictors.</p></sec><sec id="S3"><title>Results</title><p id="P3">Three hundred and nine patients were included. Forty-nine (16%) had died by the conclusion of the study. In univariate analysis, the strongest predictors of mortality were a CD4 cell count <50/μl (hazard ratio (HR) 3.70, 95% confidence interval (CI) 1.96 − 7.14), a haemoglobin concentration ≤8 g/dl (HR 1.23, 95% CI 1.08 − 1.40), a history of oral candidiasis (HR 3.17, 95% CI 1.70 − 5.87) and a history of cryptococcal meningitis (HR 2.76, 95% CI 1.80 − 19.2). A CD4 cell count <50/μl (HR 3.08, 95% CI 1.54 − 5.88) and a history of oral candidiasis (HR 2.58, 95% CI 1.37 − 4.88) remained significant in multivariate analysis. A history of tuberculosis was not a significant predictor of mortality.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Simple clinical and laboratory data independently predict mortality and allow for risk stratification in patients initiating ART in South Africa. Interventions enabling patients to be identified before they develop these clinical markers and earlier initiation of ART will help to ensure maximum benefits of therapy.</p></sec></abstract><contract-num rid="AI1">R01 AI058736-04</contract-num><contract-num rid="AI1">P30 AI060354-03</contract-num><contract-num rid="AI1">K25 AI050436-05</contract-num><contract-num rid="AI1">K24 AI062476-04</contract-num><contract-num rid="AI1">K23 AI001794-05</contract-num><contract-sponsor id="AI1">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</contract-sponsor></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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