TITLE:
Mortality of HIV-Infected Patients on Antiretroviral Therapy in a Large Public Cohort in West Africa, Burkina Faso: Frequency and Associated Factors
AUTHORS:
Armel Poda, Arsène Hema, Jacques Zoungrana, Nongodo Firmin Kaboré, Bebar Euloges Kamboulé, Ibrahim Soré, Guillaume Bado, Abdoul-Salam Ouédraogo, Nicolas Meda, Adrien Bruno Sawadogo
KEYWORDS:
Antiretroviral Therapy; Burkina Faso; HIV; Mortality; West Africa
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.3 No.4,
December
19,
2013
ABSTRACT:
Background: In sub Saharan Africa, small size
surveys have demonstrated early high mortality among infected patients on antiretroviral therapies (ART). Few studies have
been conducted in large cohorts of HIV-patients in public health care system in West Africa. Objectives: Our study aims to determine
mortality rate and its predictors in a cohort of patients on ART in a public daycare hospital in Burkina Faso. Methods: We have carried out a retrospective cohort study. All
HIV-infected patients on ART between January 1st 2008 and December 31st 2011
were included in the study. Survival probability was estimated by the
Kaplan-Meier method. Cox regression analysis was used to identify associated
factors to mortality. Results: A total of 2243
HIV-infected patients were included in the study. During the follow-up, 218 patients
representing 9.7% were lost. About 104
patients representing 4.6% were transferred and 1691 representing 75.4% were still in the therapeutic
cohort. There were 230 death cases for a total of 4282 persons-years, (5.4 deaths for 100 persons-years; 95% CI: 4.8 -6.3). The survival probabilities after 6 months, 1 year and 2 years were 92.6%, 91% and 88.9%
respectively. For the multivariate
analysis, the following factors were independently associated to death: male
gender, BMI .5 kg/m2, WHO stage 3 and 4, HIV-2, T-CD4 lymphocytes g/dl and
creatinine clearance 2. Conclusions: Our study provides for
the first time mortality rates and its predictors among HIV-patients on
antiretroviral treatment in a large cohort in public health sector in Burkina
Faso. It highlights the importance of early HIV screening to limit ART
initiation at advanced HIV infection stages.