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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Gender Differences in Mortality and CD4 Count Response Among Virally Suppressed HIV-Positive Patients</title><author><name sortKey="Maskew, Mhairi" sort="Maskew, Mhairi" uniqKey="Maskew M" first="Mhairi" last="Maskew">Mhairi Maskew</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation></author><author><name sortKey="Brennan, Alana T" sort="Brennan, Alana T" uniqKey="Brennan A" first="Alana T." last="Brennan">Alana T. Brennan</name><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation></author><author><name sortKey="Westreich, Daniel" sort="Westreich, Daniel" uniqKey="Westreich D" first="Daniel" last="Westreich">Daniel Westreich</name><affiliation><nlm:aff id="aff4"></nlm:aff></affiliation></author><author><name sortKey="Mcnamara, Lynne" sort="Mcnamara, Lynne" uniqKey="Mcnamara L" first="Lynne" last="Mcnamara">Lynne Mcnamara</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation></author><author><name sortKey="Macphail, A Patrick" sort="Macphail, A Patrick" uniqKey="Macphail A" first="A. Patrick" last="Macphail">A. Patrick Macphail</name><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P." last="Fox">Matthew P. Fox</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation><affiliation><nlm:aff id="aff6"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23350862</idno><idno type="pmc">3579326</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579326</idno><idno type="RBID">PMC:3579326</idno><idno type="doi">10.1089/jwh.2012.3585</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001720</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001720</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Gender Differences in Mortality and CD4 Count Response Among Virally Suppressed HIV-Positive Patients</title><author><name sortKey="Maskew, Mhairi" sort="Maskew, Mhairi" uniqKey="Maskew M" first="Mhairi" last="Maskew">Mhairi Maskew</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation></author><author><name sortKey="Brennan, Alana T" sort="Brennan, Alana T" uniqKey="Brennan A" first="Alana T." last="Brennan">Alana T. Brennan</name><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation></author><author><name sortKey="Westreich, Daniel" sort="Westreich, Daniel" uniqKey="Westreich D" first="Daniel" last="Westreich">Daniel Westreich</name><affiliation><nlm:aff id="aff4"></nlm:aff></affiliation></author><author><name sortKey="Mcnamara, Lynne" sort="Mcnamara, Lynne" uniqKey="Mcnamara L" first="Lynne" last="Mcnamara">Lynne Mcnamara</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation></author><author><name sortKey="Macphail, A Patrick" sort="Macphail, A Patrick" uniqKey="Macphail A" first="A. Patrick" last="Macphail">A. Patrick Macphail</name><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Fox, Matthew P" sort="Fox, Matthew P" uniqKey="Fox M" first="Matthew P." last="Fox">Matthew P. Fox</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation><affiliation><nlm:aff id="aff6"></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Women's Health</title><idno type="ISSN">1540-9996</idno><idno type="eISSN">1931-843X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec><title>Background</title><p>Treatment outcomes for antiretroviral therapy (ART) patients may vary by gender, but estimates from current evidence may be confounded by disease stage and adherence. We investigated the gender differences in treatment response among HIV-positive patients virally suppressed within 6 months of treatment initiation.</p></sec><sec><title>Methods</title><p>We analyzed data from 7,354 patients initiating ART between April 2004 and April 2010 at Themba Lethu Clinic, a large urban public sector treatment facility in South Africa. We estimated the relations among gender, mortality, and mean CD4 response in HIV-infected adults virally suppressed within 6 months of treatment initiation and used inverse probability of treatment weights to correct estimates for loss to follow-up.</p></sec><sec><title>Results</title><p>Male patients had a 20% greater risk of death at both 24 months and 36 months of follow-up compared to females. Older patients and those with a low hemoglobin level or low body mass index (BMI) were at increased risk of mortality throughout follow-up. Men gained fewer CD4 cells after treatment initiation than did women. The mean differences in CD4 count gains made by women and men between baseline and 12, 24, and 36 months were 28.2 cells/mm<sup>3</sup> (95% confidence interval [CI] 22.2–34.3), 60.8 cells/mm<sup>3</sup> (95% CI 71.1-50.5 cells/mm<sup>3</sup>), and 83.0 cells/mm<sup>3</sup> (95% CI 97.1-68.8 cells/mm<sup>3</sup>), respectively. Additionally, patients with a current detectable viral load (>400 copies/mL) and older patients had a lower mean CD4 increase at the same time points.</p></sec><sec><title>Conclusions</title><p>In this initially virally suppressed population, women showed consistently better immune response to treatment than did men. Promoting earlier uptake of HIV treatment among men may improve their immunologic outcomes.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Womens Health (Larchmt)</journal-id><journal-id journal-id-type="iso-abbrev">J Womens Health (Larchmt)</journal-id><journal-id journal-id-type="publisher-id">jwh</journal-id><journal-title-group><journal-title>Journal of Women's Health</journal-title></journal-title-group><issn pub-type="ppub">1540-9996</issn><issn pub-type="epub">1931-843X</issn><publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name><publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23350862</article-id><article-id pub-id-type="pmc">3579326</article-id><article-id pub-id-type="publisher-id">10.1089/jwh.2012.3585</article-id><article-id pub-id-type="doi">10.1089/jwh.2012.3585</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Gender Differences in Mortality and CD4 Count Response Among Virally Suppressed HIV-Positive Patients</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Maskew</surname><given-names>Mhairi</given-names></name><degrees>MBBCh</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Brennan</surname><given-names>Alana T.</given-names></name><degrees>MPH</degrees><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Westreich</surname><given-names>Daniel</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>McNamara</surname><given-names>Lynne</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>MacPhail</surname><given-names>A. Patrick</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Fox</surname><given-names>Matthew P.</given-names></name><degrees>DSc</degrees><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><aff id="aff1"><label><sup>1</sup></label>Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences,<institution>University of the Witwatersrand</institution>, Johannesburg,<country>South Africa</country>.</aff><aff id="aff2"><label><sup>2</sup></label>Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences,<institution>University of the Witwatersrand</institution>, Johannesburg,<country>South Africa</country>.</aff><aff id="aff3"><label><sup>3</sup></label><institution>Center for Global Health and Development</institution>, Boston, Massachusetts.</aff><aff id="aff4"><label><sup>4</sup></label>Gillings School of Global Public Health,<institution>University of North Carolina at Chapel Hill</institution>, North Carolina.</aff><aff id="aff5"><label><sup>5</sup></label><institution>Right to Care</institution>, Johannesburg,<country>South Africa</country>.</aff><aff id="aff6"><label><sup>6</sup></label>Department of Epidemiology,<institution>Boston University School of Public Health</institution>, Boston, Massachusetts.</aff></contrib-group><author-notes><corresp>Address correspondence to: <italic>Mhairi Maskew, MBBCh, Health Economics and Epidemiology Research Office, Themba Lethu Clinic, Helen Joseph Hospital, Perth Road, Westdene, 2041, South Africa. E-mail:</italic><email xlink:href="mailto:mmaskew@witshealth.co.za">mmaskew@witshealth.co.za</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2013</year><pmc-comment>string-date: February 2013</pmc-comment>
</pub-date><volume>22</volume><issue>2</issue><fpage>113</fpage><lpage>120</lpage><permissions><copyright-statement>Copyright 2013, Mary Ann Liebert, Inc.</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri xlink:type="simple" xlink:href="jwh.2012.3585.pdf"></self-uri><abstract><title>Abstract</title><sec><title>Background</title><p>Treatment outcomes for antiretroviral therapy (ART) patients may vary by gender, but estimates from current evidence may be confounded by disease stage and adherence. We investigated the gender differences in treatment response among HIV-positive patients virally suppressed within 6 months of treatment initiation.</p></sec><sec><title>Methods</title><p>We analyzed data from 7,354 patients initiating ART between April 2004 and April 2010 at Themba Lethu Clinic, a large urban public sector treatment facility in South Africa. We estimated the relations among gender, mortality, and mean CD4 response in HIV-infected adults virally suppressed within 6 months of treatment initiation and used inverse probability of treatment weights to correct estimates for loss to follow-up.</p></sec><sec><title>Results</title><p>Male patients had a 20% greater risk of death at both 24 months and 36 months of follow-up compared to females. Older patients and those with a low hemoglobin level or low body mass index (BMI) were at increased risk of mortality throughout follow-up. Men gained fewer CD4 cells after treatment initiation than did women. The mean differences in CD4 count gains made by women and men between baseline and 12, 24, and 36 months were 28.2 cells/mm<sup>3</sup> (95% confidence interval [CI] 22.2–34.3), 60.8 cells/mm<sup>3</sup> (95% CI 71.1-50.5 cells/mm<sup>3</sup>), and 83.0 cells/mm<sup>3</sup> (95% CI 97.1-68.8 cells/mm<sup>3</sup>), respectively. Additionally, patients with a current detectable viral load (>400 copies/mL) and older patients had a lower mean CD4 increase at the same time points.</p></sec><sec><title>Conclusions</title><p>In this initially virally suppressed population, women showed consistently better immune response to treatment than did men. Promoting earlier uptake of HIV treatment among men may improve their immunologic outcomes.</p></sec></abstract><counts><fig-count count="1"></fig-count><table-count count="3"></table-count><ref-count count="55"></ref-count><page-count count="8"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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