Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies
Identifieur interne : 000588 ( Ncbi/Merge ); précédent : 000587; suivant : 000589Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies
Auteurs :Source :
- Sexually Transmitted Infections [ 1368-4973 ] ; 2008.
Abstract
Estimation of the number of people in need of antiretroviral therapy (ART) in resource-limited settings requires information on the time from seroconversion to ART eligibility and from ART eligibility to death.
To estimate duration from seroconversion to different ART eligibility criteria and from ART eligibility to death in HIV-infected adults in low-income and middle-income countries.
Participants with documented seroconversion from five cohorts (two cohorts from Uganda, two from Thailand and one from Côte d’Ivoire) were analysed. We used Weibull survival models and Bayesian simulation methods to model true (unobserved) first time of treatment eligibility. We set a consistency constraint so that the mean duration from seroconversion to death was equal to the mean from seroconversion to ART eligibility plus the mean from eligibility to death.
We analysed data from 2072 participants, 16 157 person-years of follow-up and 794 deaths. For the criterion CD4 T-lymphocyte count <200 cells ×106/l, the median duration from seroconversion to ART eligibility was 6.1 years (95% credibility interval 3.3–10.4) for all studies and 7.6 years (95% credibility interval 3.4–15.2) for all but the Thai cohorts. Corresponding estimates for the time from CD4 T-lymphocyte count <200 cells ×106/l to death were 2.1 years (0.7–4.8) and 2.7 years (0.8–8.4). When including all cohorts, the mean time from serconversion to CD4 T-lymphocyte count <200 cells ×106/l and from CD4 T-lymphocyte count <200 cells ×106/l to death represented 66% (38–87%) and 34% (13–62%), respectively of the total survival time.
The duration of different ART eligibility criteria to death was longer than the estimates used in previous calculations of the number of people needing ART. However, uncertainty in estimates was considerable and heterogeneity across cohorts important.
Url:
DOI: 10.1136/sti.2008.029793
PubMed: 18647863
PubMed Central: 2569418
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</title></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18647863</idno><idno type="pmc">2569418</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418</idno><idno type="RBID">PMC:2569418</idno><idno type="doi">10.1136/sti.2008.029793</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">002C73</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002C73</idno><idno type="wicri:Area/Pmc/Curation">002C72</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002C72</idno><idno type="wicri:Area/Pmc/Checkpoint">002A14</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002A14</idno><idno type="wicri:Area/Ncbi/Merge">000588</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</title></analytic><series><title level="j">Sexually Transmitted Infections</title><idno type="ISSN">1368-4973</idno><idno type="eISSN">1472-3263</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><title>Background:</title><p>Estimation of the number of people in need of antiretroviral therapy (ART) in resource-limited settings requires information on the time from seroconversion to ART eligibility and from ART eligibility to death.</p></sec><sec><title>Objectives:</title><p>To estimate duration from seroconversion to different ART eligibility criteria and from ART eligibility to death in HIV-infected adults in low-income and middle-income countries.</p></sec><sec><title>Methods:</title><p>Participants with documented seroconversion from five cohorts (two cohorts from Uganda, two from Thailand and one from Côte d’Ivoire) were analysed. We used Weibull survival models and Bayesian simulation methods to model true (unobserved) first time of treatment eligibility. We set a consistency constraint so that the mean duration from seroconversion to death was equal to the mean from seroconversion to ART eligibility plus the mean from eligibility to death.</p></sec><sec><title>Results:</title><p>We analysed data from 2072 participants, 16 157 person-years of follow-up and 794 deaths. For the criterion CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l, the median duration from seroconversion to ART eligibility was 6.1 years (95% credibility interval 3.3–10.4) for all studies and 7.6 years (95% credibility interval 3.4–15.2) for all but the Thai cohorts. Corresponding estimates for the time from CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l to death were 2.1 years (0.7–4.8) and 2.7 years (0.8–8.4). When including all cohorts, the mean time from serconversion to CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l and from CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l to death represented 66% (38–87%) and 34% (13–62%), respectively of the total survival time.</p></sec><sec><title>Conclusions:</title><p>The duration of different ART eligibility criteria to death was longer than the estimates used in previous calculations of the number of people needing ART. However, uncertainty in estimates was considerable and heterogeneity across cohorts important.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Boerma, Jt" uniqKey="Boerma J">JT Boerma</name></author><author><name sortKey="Stanecki, Ka" uniqKey="Stanecki K">KA Stanecki</name></author><author><name sortKey="Newell, Ml" uniqKey="Newell M">ML Newell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stover, J" uniqKey="Stover J">J Stover</name></author><author><name sortKey="Bertozzi, S" uniqKey="Bertozzi S">S Bertozzi</name></author><author><name sortKey="Gutierrez, Jp" uniqKey="Gutierrez J">JP Gutierrez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hammer, Sm" uniqKey="Hammer S">SM Hammer</name></author><author><name sortKey="Saag, Ms" uniqKey="Saag M">MS Saag</name></author><author><name sortKey="Schechter, M" uniqKey="Schechter M">M Schechter</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Stewart, La" uniqKey="Stewart L">LA Stewart</name></author><author><name sortKey="Tierney, Jf" uniqKey="Tierney J">JF Tierney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Todd, J" uniqKey="Todd J">J Todd</name></author><author><name sortKey="Glynn, Jr" uniqKey="Glynn J">JR Glynn</name></author><author><name sortKey="Marston, M" uniqKey="Marston M">M Marston</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Minga, A" uniqKey="Minga A">A Minga</name></author><author><name sortKey="Danel, C" uniqKey="Danel C">C Danel</name></author><author><name sortKey="Abo, Y" uniqKey="Abo Y">Y Abo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wawer, Mj" uniqKey="Wawer M">MJ Wawer</name></author><author><name sortKey="Serwadda, D" uniqKey="Serwadda D">D Serwadda</name></author><author><name sortKey="Gray, Rh" uniqKey="Gray R">RH Gray</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morgan, D" uniqKey="Morgan D">D Morgan</name></author><author><name sortKey="Malamba, Ss" uniqKey="Malamba S">SS Malamba</name></author><author><name sortKey="Maude, Gh" uniqKey="Maude G">GH Maude</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rangsin, R" uniqKey="Rangsin R">R Rangsin</name></author><author><name sortKey="Chiu, J" uniqKey="Chiu J">J Chiu</name></author><author><name sortKey="Khamboonruang, C" uniqKey="Khamboonruang C">C Khamboonruang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nagachinta, T" uniqKey="Nagachinta T">T Nagachinta</name></author><author><name sortKey="Duerr, A" uniqKey="Duerr A">A Duerr</name></author><author><name sortKey="Suriyanon, V" uniqKey="Suriyanon V">V Suriyanon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lee, Et" uniqKey="Lee E">ET Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lunn, Dj" uniqKey="Lunn D">DJ Lunn</name></author><author><name sortKey="Thomas, A" uniqKey="Thomas A">A Thomas</name></author><author><name sortKey="Best, N" uniqKey="Best N">N Best</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stewart, La" uniqKey="Stewart L">LA Stewart</name></author><author><name sortKey="Parmar, Mk" uniqKey="Parmar M">MK Parmar</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schneider, M" uniqKey="Schneider M">M Schneider</name></author><author><name sortKey="Zwahlen, M" uniqKey="Zwahlen M">M Zwahlen</name></author><author><name sortKey="Egger, M" uniqKey="Egger M">M Egger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zwahlen, M" uniqKey="Zwahlen M">M Zwahlen</name></author><author><name sortKey="Egger, M" uniqKey="Egger M">M Egger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Altman, Dg" uniqKey="Altman D">DG Altman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zaba, B" uniqKey="Zaba B">B Zaba</name></author><author><name sortKey="Marston, M" uniqKey="Marston M">M Marston</name></author><author><name sortKey="Crampin, Ac" uniqKey="Crampin A">AC Crampin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ghys, Pd" uniqKey="Ghys P">PD Ghys</name></author><author><name sortKey="Zaba, B" uniqKey="Zaba B">B Zaba</name></author><author><name sortKey="Prins, M" uniqKey="Prins M">M Prins</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dabis, F" uniqKey="Dabis F">F Dabis</name></author><author><name sortKey="Balestre, E" uniqKey="Balestre E">E Balestre</name></author><author><name sortKey="Braitstein, P" uniqKey="Braitstein P">P Braitstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Braitstein, P" uniqKey="Braitstein P">P Braitstein</name></author><author><name sortKey="Brinkhof, Mw" uniqKey="Brinkhof M">MW Brinkhof</name></author><author><name sortKey="Dabis, F" uniqKey="Dabis F">F Dabis</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Marston, M" uniqKey="Marston M">M Marston</name></author><author><name sortKey="Todd, J" uniqKey="Todd J">J Todd</name></author><author><name sortKey="Glynn, Jr" uniqKey="Glynn J">JR Glynn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nelson, Ke" uniqKey="Nelson K">KE Nelson</name></author><author><name sortKey="Costello, C" uniqKey="Costello C">C Costello</name></author><author><name sortKey="Suriyanon, V" uniqKey="Suriyanon V">V Suriyanon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rangsin, R" uniqKey="Rangsin R">R Rangsin</name></author><author><name sortKey="Piyaraj, P" uniqKey="Piyaraj P">P Piyaraj</name></author><author><name sortKey="Sirisanthana, T" uniqKey="Sirisanthana T">T Sirisanthana</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Van Der Paal, L" uniqKey="Van Der Paal L">L Van der Paal</name></author><author><name sortKey="Shafer, La" uniqKey="Shafer L">LA Shafer</name></author><author><name sortKey="Todd, J" uniqKey="Todd J">J Todd</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lutalo, T" uniqKey="Lutalo T">T Lutalo</name></author><author><name sortKey="Gray, Rh" uniqKey="Gray R">RH Gray</name></author><author><name sortKey="Wawer, M" uniqKey="Wawer M">M Wawer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Grimwade, K" uniqKey="Grimwade K">K Grimwade</name></author><author><name sortKey="Swingler, G" uniqKey="Swingler G">G Swingler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stover, J" uniqKey="Stover J">J Stover</name></author><author><name sortKey="Johnson, P" uniqKey="Johnson P">P Johnson</name></author><author><name sortKey="Zaba, B" uniqKey="Zaba B">B Zaba</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morgan, D" uniqKey="Morgan D">D Morgan</name></author><author><name sortKey="Maude, Gh" uniqKey="Maude G">GH Maude</name></author><author><name sortKey="Malamba, Ss" uniqKey="Malamba S">SS Malamba</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sewankambo, Nk" uniqKey="Sewankambo N">NK Sewankambo</name></author><author><name sortKey="Gray, Rh" uniqKey="Gray R">RH Gray</name></author><author><name sortKey="Ahmad, S" uniqKey="Ahmad S">S Ahmad</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lawn, Sd" uniqKey="Lawn S">SD Lawn</name></author><author><name sortKey="Myer, L" uniqKey="Myer L">L Myer</name></author><author><name sortKey="Orrell, C" uniqKey="Orrell C">C Orrell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Costello, C" uniqKey="Costello C">C Costello</name></author><author><name sortKey="Nelson, Ke" uniqKey="Nelson K">KE Nelson</name></author><author><name sortKey="Suriyanon, V" uniqKey="Suriyanon V">V Suriyanon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Badri, M" uniqKey="Badri M">M Badri</name></author><author><name sortKey="Bekker, Lg" uniqKey="Bekker L">LG Bekker</name></author><author><name sortKey="Orrell, C" uniqKey="Orrell C">C Orrell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schim Van Der Loeff, Mf" uniqKey="Schim Van Der Loeff M">MF Schim van der Loeff</name></author><author><name sortKey="Jaffar, S" uniqKey="Jaffar S">S Jaffar</name></author><author><name sortKey="Aveika, Aa" uniqKey="Aveika A">AA Aveika</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kilmarx, Ph" uniqKey="Kilmarx P">PH Kilmarx</name></author><author><name sortKey="Limpakarnjanarat, K" uniqKey="Limpakarnjanarat K">K Limpakarnjanarat</name></author><author><name sortKey="Kaewkungwal, J" uniqKey="Kaewkungwal J">J Kaewkungwal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="French, N" uniqKey="French N">N French</name></author><author><name sortKey="Mujugira, A" uniqKey="Mujugira A">A Mujugira</name></author><author><name sortKey="Nakiyingi, J" uniqKey="Nakiyingi J">J Nakiyingi</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Sex Transm Infect</journal-id><journal-id journal-id-type="publisher-id">sti</journal-id><journal-title-group><journal-title>Sexually Transmitted Infections</journal-title></journal-title-group><issn pub-type="ppub">1368-4973</issn><issn pub-type="epub">1472-3263</issn><publisher><publisher-name>BMJ Publishing Group</publisher-name><publisher-loc>BMA House, Tavistock Square, London, WC1H 9JR</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18647863</article-id><article-id pub-id-type="pmc">2569418</article-id><article-id pub-id-type="publisher-id">st29793</article-id><article-id pub-id-type="doi">10.1136/sti.2008.029793</article-id><article-categories><subj-group subj-group-type="heading"><subject>Supplement</subject></subj-group></article-categories><title-group><article-title>Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</article-title><alt-title alt-title-type="running-head">Supplement</alt-title></title-group><contrib-group><contrib contrib-type="author"><collab>The eligibility for ART in lower income countries (eART-linc) collaboration</collab></contrib></contrib-group><author-notes><corresp>Correspondence to: Dr Marcel Zwahlen, Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland; <email>eART-linc@ispm.unibe.ch</email></corresp></author-notes><pub-date pub-type="collection"><year>2008</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>22</day><month>7</month><year>2008</year></pub-date><pub-date pub-type="pmc-release"><day>22</day><month>7</month><year>2008</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<volume>84</volume><issue>Suppl_1</issue><issue-title>Improved data, methods and tools for the 2007 HIV and AIDS estimates and projections</issue-title><fpage>i31</fpage><lpage>i36</lpage><history><date date-type="accepted"><day>13</day><month>5</month><year>2008</year></date></history><permissions><copyright-statement>© The eligibility for ART in lower income countries (eART-linc) collaboration 2008</copyright-statement><copyright-year>2008</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Background:</title><p>Estimation of the number of people in need of antiretroviral therapy (ART) in resource-limited settings requires information on the time from seroconversion to ART eligibility and from ART eligibility to death.</p></sec><sec><title>Objectives:</title><p>To estimate duration from seroconversion to different ART eligibility criteria and from ART eligibility to death in HIV-infected adults in low-income and middle-income countries.</p></sec><sec><title>Methods:</title><p>Participants with documented seroconversion from five cohorts (two cohorts from Uganda, two from Thailand and one from Côte d’Ivoire) were analysed. We used Weibull survival models and Bayesian simulation methods to model true (unobserved) first time of treatment eligibility. We set a consistency constraint so that the mean duration from seroconversion to death was equal to the mean from seroconversion to ART eligibility plus the mean from eligibility to death.</p></sec><sec><title>Results:</title><p>We analysed data from 2072 participants, 16 157 person-years of follow-up and 794 deaths. For the criterion CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l, the median duration from seroconversion to ART eligibility was 6.1 years (95% credibility interval 3.3–10.4) for all studies and 7.6 years (95% credibility interval 3.4–15.2) for all but the Thai cohorts. Corresponding estimates for the time from CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l to death were 2.1 years (0.7–4.8) and 2.7 years (0.8–8.4). When including all cohorts, the mean time from serconversion to CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l and from CD4 T-lymphocyte count <200 cells ×10<sup>6</sup>/l to death represented 66% (38–87%) and 34% (13–62%), respectively of the total survival time.</p></sec><sec><title>Conclusions:</title><p>The duration of different ART eligibility criteria to death was longer than the estimates used in previous calculations of the number of people needing ART. However, uncertainty in estimates was considerable and heterogeneity across cohorts important.</p></sec></abstract></article-meta></front></pmc><affiliations><list></list><tree></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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