Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi: a retrospective cohort analysis.
Identifieur interne : 000A12 ( PubMed/Curation ); précédent : 000A11; suivant : 000A13Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi: a retrospective cohort analysis.
Auteurs : Emmanuel Singogo [Royaume-Uni] ; Thomas J. Keegan [Royaume-Uni] ; Peter J. Diggle [Royaume-Uni] ; Monique Van Lettow [Malawi] ; Alfred Matengeni [Malawi] ; Joep J. Van Oosterhout [Malawi] ; Sumeet Sodhi [Malawi] ; Martias Joshua [Malawi] ; Benjamin M. Taylor [Royaume-Uni]Source :
- International health [ 1876-3405 ] ; 2017.
Descripteurs français
- KwdFr :
- MESH :
- mortalité : Infections à VIH, Sarcome de Kaposi.
- virologie : Sarcome de Kaposi.
- épidémiologie : Malawi.
- Adolescent, Adulte, Adulte d'âge moyen, Analyse de survie, Femelle, Humains, Infections à VIH, Jeune adulte, Mâle, Études rétrospectives.
English descriptors
- KwdEn :
- MESH :
- complications : HIV Infections.
- epidemiology : Malawi.
- mortality : HIV Infections, Sarcoma, Kaposi.
- therapy : HIV Infections.
- virology : Sarcoma, Kaposi.
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Survival Analysis, Young Adult.
Abstract
The HIV epidemic is a major public health concern throughout Africa. Malawi is one of the worst affected countries in sub-Saharan Africa with a 2014 national HIV prevalence currently estimated at 10% (9.3-10.8%) by UNAIDS. Study reports, largely in the African setting comparing outcomes in HIV patients with and without Kaposi's sarcoma (KS) indicate poor prognosis and poor health outcomes amongst HIV+KS patients. Understanding the mortality risk in this patient group could help improve patient management and care.
DOI: 10.1093/inthealth/ihx027
PubMed: 28911125
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pubmed:28911125Le document en format XML
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<term>HIV Infections (complications)</term>
<term>HIV Infections (mortality)</term>
<term>HIV Infections (therapy)</term>
<term>Humans</term>
<term>Malawi (epidemiology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
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<term>Sarcoma, Kaposi (virology)</term>
<term>Survival Analysis</term>
<term>Young Adult</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Femelle</term>
<term>Humains</term>
<term>Infections à VIH ()</term>
<term>Infections à VIH (mortalité)</term>
<term>Jeune adulte</term>
<term>Malawi (épidémiologie)</term>
<term>Mâle</term>
<term>Sarcome de Kaposi (mortalité)</term>
<term>Sarcome de Kaposi (virologie)</term>
<term>Études rétrospectives</term>
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<term>Sarcoma, Kaposi</term>
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<term>Sarcome de Kaposi</term>
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<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Sarcome de Kaposi</term>
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<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Sarcoma, Kaposi</term>
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<term>Adult</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Survival Analysis</term>
<term>Young Adult</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Femelle</term>
<term>Humains</term>
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<front><div type="abstract" xml:lang="en">The HIV epidemic is a major public health concern throughout Africa. Malawi is one of the worst affected countries in sub-Saharan Africa with a 2014 national HIV prevalence currently estimated at 10% (9.3-10.8%) by UNAIDS. Study reports, largely in the African setting comparing outcomes in HIV patients with and without Kaposi's sarcoma (KS) indicate poor prognosis and poor health outcomes amongst HIV+KS patients. Understanding the mortality risk in this patient group could help improve patient management and care.</div>
</front>
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<DateCreated><Year>2017</Year>
<Month>09</Month>
<Day>15</Day>
</DateCreated>
<DateCompleted><Year>2017</Year>
<Month>09</Month>
<Day>25</Day>
</DateCompleted>
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<Month>09</Month>
<Day>25</Day>
</DateRevised>
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<JournalIssue CitedMedium="Internet"><Volume>9</Volume>
<Issue>5</Issue>
<PubDate><Year>2017</Year>
<Month>Sep</Month>
<Day>01</Day>
</PubDate>
</JournalIssue>
<Title>International health</Title>
<ISOAbbreviation>Int Health</ISOAbbreviation>
</Journal>
<ArticleTitle>Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi: a retrospective cohort analysis.</ArticleTitle>
<Pagination><MedlinePgn>281-287</MedlinePgn>
</Pagination>
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<Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">The HIV epidemic is a major public health concern throughout Africa. Malawi is one of the worst affected countries in sub-Saharan Africa with a 2014 national HIV prevalence currently estimated at 10% (9.3-10.8%) by UNAIDS. Study reports, largely in the African setting comparing outcomes in HIV patients with and without Kaposi's sarcoma (KS) indicate poor prognosis and poor health outcomes amongst HIV+KS patients. Understanding the mortality risk in this patient group could help improve patient management and care.</AbstractText>
<AbstractText Label="Methods" NlmCategory="UNASSIGNED">Using data for the 559 adult HIV+KS patients who started ART between 2004 and September 2011 at Zomba clinic in Malawi, we estimated relative hazard ratios for all-cause mortality by controlling for age, sex, TB status, occupation, date of starting treatment and distance to the HIV+KS clinic.</AbstractText>
<AbstractText Label="Results" NlmCategory="UNASSIGNED">Patients with tuberculosis (95% CI: 1.05-4.65) and patients who started ART before 2008 (95% CI: 0.34-0.81) were at significantly greater risk of dying. A random-effects Cox model with Log-Gaussian frailties adequately described the variation in the hazard for mortality.</AbstractText>
<AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">The year of starting ART and TB status significantly affected survival among HIV+KS patients. A sub-population analysis of this kind can inform an efficient triage system for managing vulnerable patients.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Singogo</LastName>
<ForeName>Emmanuel</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Lancaster Medical School, Lancaster University, LA1 4YF, Lancashire, UK.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Keegan</LastName>
<ForeName>Thomas J</ForeName>
<Initials>TJ</Initials>
<AffiliationInfo><Affiliation>Lancaster Medical School, Lancaster University, LA1 4YF, Lancashire, UK.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Diggle</LastName>
<ForeName>Peter J</ForeName>
<Initials>PJ</Initials>
<AffiliationInfo><Affiliation>Lancaster Medical School, Lancaster University, LA1 4YF, Lancashire, UK.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>van Lettow</LastName>
<ForeName>Monique</ForeName>
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<AffiliationInfo><Affiliation>Dignitas International, Zomba, Malawi.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Matengeni</LastName>
<ForeName>Alfred</ForeName>
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<ForeName>Joep J</ForeName>
<Initials>JJ</Initials>
<AffiliationInfo><Affiliation>Dignitas International, Zomba, Malawi.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Sodhi</LastName>
<ForeName>Sumeet</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Dignitas International, Zomba, Malawi.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Joshua</LastName>
<ForeName>Martias</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Zomba Central Hospital, Malawi.</Affiliation>
</AffiliationInfo>
</Author>
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<Initials>BM</Initials>
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<MeshHeading><DescriptorName UI="D012514" MajorTopicYN="N">Sarcoma, Kaposi</DescriptorName>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">AIDS-associated</Keyword>
<Keyword MajorTopicYN="N">Antiretroviral therapy</Keyword>
<Keyword MajorTopicYN="N">Kaposis sarcoma</Keyword>
<Keyword MajorTopicYN="N">Survival</Keyword>
</KeywordList>
</MedlineCitation>
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<Month>01</Month>
<Day>18</Day>
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