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HIV progression and predictors of mortality in a community-based cohort of Zambian adults.

Kitchen, Maria; Quigley, Maria A; Mwinga, Alwyn M; Fuchs, Dietmar; Lisse, Ida M; Porter, John D H; McAdam, Keith P W J; Godfrey-Faussett, Peter.
J Int Assoc Physicians AIDS Care (Chic); 7(1): 17-26, 2008 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17989427
This article describes immunological HIV progression, mortality, and its predictors in 974 Zambian adults. During 3138 person-years of follow-up, 281 deaths occurred, and the overall mortality rate was 9.0 per 100 person-years. Thirty-six percent of patients were dead within 5 years of enrollment. The median survival in patients with baseline CD4 count ≥500 cells/mm³ was 5.62 years, with CD4 count between 200 and 499 cells/mm³ 5.46 years, and with CD4 count <200 cells/mm³ 3.89 years. The mortality rate increased significantly with older age (6.9 in patients <25 years, 9.3 in individuals aged 25-39 years, 10.2 in patients ≥40 years) and was higher in women (rate ratio 1.29). The median annual change of progression markers was -29.6 cells/mm³ for CD4 count, -3.0% for CD4 count percentage, 1.2 nmol/L for neopterin, -1.9 g/L for hemoglobin, and -70 cells/mm³ for total lymphocyte count. Hemoglobin and neopterin were as accurate as CD4 count to predict mortality.
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