Use of darunavir in HIV-1-infected individuals in routine clinical practice from 2012 to 2016 in France

2019 ◽  
Vol 74 (11) ◽  
pp. 3305-3314 ◽  
Author(s):  
Valérie Potard ◽  
Ana Canestri ◽  
Sebastien Gallien ◽  
Dominique Costagliola ◽  
S Abgrall ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Dual Therapy ◽  
People Living With Hiv ◽  
Subdistribution Hazard ◽  
Loss To Follow Up ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Virological Outcomes ◽  
Hiv 1

Abstract Objectives We assessed virological outcomes of darunavir use in France from 2012 to 2016, in three groups of people living with HIV (PLHIV): (i) antiretroviral (ARV)-naive PLHIV; (ii) ARV-experienced PLHIV switching to darunavir while failing therapy; and (iii) ARV-experienced PLHIV switching to darunavir while virologically controlled. Methods Virological success (VS) was defined as a plasma HIV-1 viral load (VL) <50 copies/mL and virological failure (VF) as two consecutive VL >50 copies/mL or one VL >50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering darunavir discontinuation, loss to follow-up and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Results Among the 3235 ARV-naive PLHIV initiating darunavir, the 4 year cumulative incidence of VS was 80.9% and was associated with lower VL and higher CD4 cell counts. Among the 3485 ARV-experienced PLHIV switching to darunavir while failing therapy, the 4 year cumulative incidence of VS was 82.2% and was associated with lower VL. Among the 3005 ARV-experienced PLHIV switching to darunavir while virologically controlled, the 4 year cumulative incidence of VF was 12.6%. The risk of VF was higher with darunavir monotherapy [subdistribution hazard ratio (sHR)=1.67, 95% CI 1.15–2.42] while no difference was observed with dual therapy (sHR = 1.00, 95% CI 0.71–1.42) relative to triple therapy or more. Conclusions Darunavir-containing regimens yielded similarly high rates of viral suppression in PLHIV whether they were ARV naive or ARV experienced switching to darunavir while failing therapy, or of maintaining VS in ARV-experienced PLHIV switching to darunavir while virologically controlled.

scholarly journals Use of rilpivirine in HIV-1-infected individuals in routine clinical practice from 2012 to 2017 in France

2020 ◽  
Author(s):  
Valérie Potard ◽  
Sebastien Gallien ◽  
Ana Canestri ◽  
Dominique Costagliola ◽  
S Abel ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Viral Suppression ◽  
People Living With Hiv ◽  
Loss To Follow Up ◽  
Virological Success ◽  
Virological Outcomes ◽  
Treatment Switch ◽  
Living With Hiv ◽  
Hiv 1

Abstract Objectives We assessed virological outcomes of rilpivirine use in France from 2012 to 2017, in three groups of people living with HIV (PLHIV): (i) antiretroviral (ARV)-naive PLHIV; (ii) ARV-experienced PLHIV switching to rilpivirine while failing therapy; and (iii) ARV-experienced PLHIV switching to rilpivirine while virologically controlled. Methods Virological success (VS) was defined as a plasma HIV-1 viral load (VL) &lt;50 copies/mL and virological failure (VF) as two consecutive VL &gt;50 copies/mL or one VL &gt;50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering rilpivirine discontinuation, loss to follow-up and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. Results Among the 2166 ARV-naive PLHIV initiating rilpivirine, the 4 year cumulative incidence of VS was 91.0% and was associated with baseline VL. Among the 2125 ARV-experienced PLHIV switching to rilpivirine while failing therapy, the 4 year cumulative incidence of VS was 82.5% and was associated with lower VL, higher CD4 and less than three prior ARVs. Among the 11 828 ARV-experienced PLHIV switching to rilpivirine while virologically controlled, the 4 year cumulative incidence of VF was 9.6%. The risk of VF was lower among MSM, for PLHIV with CD4 ≥ 500 cell/mm3, without a prior AIDS event, or with a longer VL suppression at baseline. Conclusions Rilpivirine-containing regimens yielded high rates of viral suppression in most participants, while it was ineffective when used outside the marketing authorization in naive participants.

scholarly journals Virologic Outcomes among People Living with HIV with High Pre-Therapy Viral Load Burden Initiating on Common Core Agents

2021 ◽  
Author(s):  
Anthony M Mills ◽  
Kathy L Schulman ◽  
Jennifer S Fusco ◽  
Michael B Wohlfeiler ◽  
Julie L Priest ◽  
...  
Keyword(s):  
Common Core ◽  
Virologic Failure ◽  
People Living With Hiv ◽  
Factors Associated ◽  
Viral Loads ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Living With Hiv ◽  
Cd4 Cell

Abstract Background People living with HIV (PLWH) initiating antiretroviral therapy (ART) with viral loads (VL) ≥100,000 copies/mL are less likely to achieve virologic success, but few studies have characterized real-world treatment outcomes. Methods ART-naïve PLWH with VLs ≥100,000 copies/mL initiating dolutegravir (DTG), elvitegravir (EVG), raltegravir (RAL) or darunavir (DRV) between 12Aug2013 and 31July2017 were identified from the OPERA Database. Virologic failure was defined as (i) 2 consecutive VLs ≥200 copies/mL after 36 weeks of ART, or (ii) 1 VL ≥200 copies/mL with core agent discontinuation after 36 weeks, or (iii) 2 consecutive VL ≥200 copies/mL after suppression (≤50 copies/mL) before 36 weeks, or (iv) 1 VL ≥200 copies/mL with discontinuation after suppression before 36 weeks. Cox modelling estimated the association between regimen and virologic failure. Results There were 2,038 ART-naïve patients with high VL who initiated DTG (36%), EVG (46%), DRV (16%) or RAL (2%). Median follow-up was 18.1 months (IQR:12.4-28.9). EVG and DTG initiators were similar at baseline but RAL initiators were older and more likely to be female with low CD4 cell counts while DRV initiators differed notably on factors associated with treatment failure. Virologic failure was experienced by 9.2% DTG, 13.2% EVG, 18.4% RAL and 18.8% DRV initiators. Compared to DTG, the adjusted hazard ratio (95% CI) was 1.46 (1.05, 2.03) for EVG, 2.24 (1.50, 3.34) for DRV, and 4.13 (1.85, 9.24) for RAL. Conclusion ART-naïve PLWH with high VLs initiating on DTG were significantly less likely to experience virologic failure compared to EVG, RAL and DRV initiators.

scholarly journals 1038. Rapid Start: A Changing Algorithm for the Management of HIV Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S549-S549
Author(s):  
Smitha Gudipati ◽  
Miriam Jaziri ◽  
Stephanie Tancer ◽  
Amit T Vahia ◽  
Indira Brar
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Standard Of Care ◽  
Heterosexual Transmission ◽  
Categorical Variables ◽  
People Living With Hiv ◽  
Hiv Diagnosis ◽  
Loss To Follow Up ◽  
Hiv 1

Abstract Background Initiating combination antiretroviral therapy (cART) as early as the day of HIV diagnosis is a strategy of increasing interest to control the HIV epidemic and optimize the health of people living with HIV. Pilot studies have shown that starting cART immediately after diagnosis has led to earlier linkage to care and HIV-1 RNA suppression. However, there is some evidence from observational studies that starting cART on the same day as HIV diagnosis may increase the risk of loss to follow-up. Consequently, there is a need for additional data for immediate cART initiation. Methods A Retrospective cohort study was conducted from 2016 to 2018 to identify clinical characteristics and risk factors in patients that were diagnosed with HIV-1 with a 4th generation assay using electronic medical records. Rapid start was defined as offering cART prior to or on the first clinic visit. Categorical variables were analyzed using chi-sq test and continuous variables were analyzed using t-test. Data analysis was done using SAS 9.4. Results In the study period, 188 patients were identified as HIV-1 positive and cART naïve: 152 males and 34 females. Risk factors included men who have sex with men (N = 86), heterosexual transmission (N = 88), intravenous drug use (N = 18) and multiple partners (N = 15). Of the 188 patients, 40 patients were rapidly started on cART on average within 6 days of diagnosis vs 42 days in the standard of care patients (P &gt; 0.0001), with a shorter duration to clinic follow up over time (P = 0.3103). 50% patients that were rapid started on cART maintained an undetectable viral load vs 77% of the standard of care group (P = 0.3174). 90% of the rapid start patients were retained in care at 12 months vs 78% of the standard of care patients (P = 0.4950). 126 patients were started on single tablet regimens (P = 0.0001) with a trend favoring bictegravir, emtricitabine & tenofovir alafenamide (P = 0.0001). Conclusion Our study adds to the growing data that rapid ART initiation within seven days of HIV diagnosis could reduce loss to follow-up, improve virological suppression rates, and reduce mortality. The percentage of patients with undetectable HIV-1 viral load and retained in care was comparable to that in standard of care, indicating that starting cART immediately after diagnosis was well accepted by patients. Disclosures Indira Brar, MD, Gilead (Speaker’s Bureau)janssen (Speaker’s Bureau)ViiV (Speaker’s Bureau)

Effectiveness and Acceptability of Delivery of Antiretroviral Treatment in Health Centres by Health Officers and Nurses in Ethiopia

2012 ◽  
Vol 17 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Yibeltal Assefa ◽  
Abiyou Kiflie ◽  
Betru Tekle ◽  
Damen Haile Mariam ◽  
Marie Laga ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Workers ◽  
Care Providers ◽  
Loss To Follow Up ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Health Centres ◽  
Cd4 Cell ◽  
Art Delivery

Objective The World Health Organization (WHO) recommends shifting tasks from physicians to lower cadres for the delivery of antiretroviral treatment (ART) for countries short of physicians. Our objective was to evaluate the effectiveness and acceptability of ART delivery by health officers and nurses in Ethiopia. Methods A retrospective cohort study to evaluate outcomes of ART services in 25 health centresstaffed with health officers and/or nurses and 30 hospitals staffed with physicians in 2009. Median CD4-cell counts, mortality, loss to follow-up and retention were the primary outcomes. Interviews and focus group discussions were conducted with people living with HIV/AIDS, AIDS programme managers and health care providers to identify the types and acceptability of the tasks conducted by the health officers, nurses and community health workers. Results Health officers and nurses were providing ART, including ART prescription, for non-severe cases. The management of severe cases was exclusively the task of physicians. Community health workers were involved in adherence counselling and defaulter tracing. The baseline median CD4-cell counts per micro-liter of blood were 117 (interquartiles [IQ] 64,188) and 119 (IQ 67,190) at health centres and hospitals respectively. After 24 months on ART, the median CD4-cell counts per micro-literof blood increased to 321 (IQ 242, 414) and 301 (IQ 217, 411) at health centres and hospitals respectively. Retention in care was higher in health centres (76%, 95% confidence interval [CI] [73%-79%]) than hospitals (67%, 95% CI [66%-68%]). This difference is mainly due to the higher loss to follow-up rate in hospitals (25% versus 13%). Mortality was higher in health centres than hospitals (11% versus 8%), but the difference is not statistically significant. Service delivery by non-physicians was accepted by patients, health care providers and programme managers. However, the absence of a regulatory framework for task shifting, the lack of extra remuneration for the additional roles assumed by nurses and health officers, and the high cost for training and mentorship were identified as weaknesses. Conclusion ART delivery in health centres, based on health officers and nurses is feasible, effective and acceptable in Ethiopia. However, issues related to regulation, remuneration and cost need to be addressed for the sustainable implementation of these delivery models.

scholarly journals Initiating antiretroviral therapy when presenting with higher CD4 cell counts results in reduced loss to follow-up in a resource-limited setting

AIDS ◽  
2013 ◽  
Vol 27 (4) ◽  
pp. 645-650 ◽  
Author(s):  
Kate Clouse ◽  
Audrey Pettifor ◽  
Mhairi Maskew ◽  
Jean Bassett ◽  
Annelies Van Rie ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Resource Limited Setting ◽  
Loss To Follow Up ◽  
Cell Counts ◽  
Resource Limited ◽  
Cd4 Cell Counts ◽  
Cd4 Cell ◽  
Limited Setting

scholarly journals Time-Dependent Predictors of Loss to Follow-Up in a Large HIV Treatment Cohort in Nigeria

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Seema Thakore Meloni ◽  
Charlotte Chang ◽  
Beth Chaplin ◽  
Holly Rawizza ◽  
Oluwatoyin Jolayemi ◽  
...  
Keyword(s):  
Viral Load ◽  
Hiv Treatment ◽  
Time Dependent ◽  
World Health ◽  
Loss To Follow Up ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Increased Risk ◽  
Cd4 Cell

Abstract Background.  Most evaluations of loss to follow-up (LTFU) in human immunodeficiency virus (HIV) treatment programs focus on baseline predictors, prior to antiretroviral therapy (ART) initiation. As risk of LTFU is a continuous issue, the aim of this evaluation was to augment existing information with further examination of time-dependent predictors of loss. Methods.  This was a retrospective evaluation of data collected between 2004 and 2012 by the Harvard School of Public Health and the AIDS Prevention Initiative in Nigeria as part of PEPFAR-funded program in Nigeria. We used multivariate modeling methods to examine associations between CD4+ cell counts, viral load, and early adherence patterns with LTFU, defined as no refills collected for at least 2 months since the last scheduled appointment. Results.  Of 51 953 patients initiated on ART between 2004 and 2011, 14 626 (28%) were LTFU by 2012. Factors associated with increased risk for LTFU were young age, having nonincome-generating occupations or no education, being unmarried, World Health Organization (WHO) stage, having a detectable viral load, and lower CD4+ cell counts. In a subset analysis, adherence patterns during the first 3 months of ART were associated with risk of LTFU by month 12. Conclusions.  In settings with limited resources, early adherence patterns, as well as CD4+ cell counts and unsuppressed viral load, at any time point in treatment are predictive of loss and serve as effective markers for developing targeted interventions to reduce rates of attrition.

scholarly journals Comparison of HIV-1 viral loads, CD4-Th2-lymphocytes and effects of praziquantel treatment among adults infected or uninfected with Schistosoma mansoni in fishing villages of north-western Tanzania

2016 ◽  
Vol 18 (4) ◽  
Author(s):  
Humphrey D. Mazigo ◽  
David W. Dunne ◽  
Domenica Morona ◽  
Safari M. Kinung'hi ◽  
Fred Nuwaha
Keyword(s):  
Viral Loads ◽  
Fishing Villages ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Praziquantel Treatment ◽  
Cd4 Cell ◽  
North Western ◽  
Hiv 1 ◽  
Western Tanzania

 Background: It is hypothesised that Th2 immunological environment associated with Schistosoma mansoni infection might favour replication of HIV-1 in co-infected individuals, results in increased viral loads. On the other hand, deworming using praziquantel might result in reduction of HIV-1 viral loads and increased CD4+ cell counts. This study was therefore, carried out to compare HIV -1 plasma loads, CD4-Th2-lymphocytes and the effects of praziquantel treatment on HIV-1 plasma loads and CD4+ cell counts among HIV-1 seropositive individuals infected or uninfected with S. mansoni.Methodology: A 9-month prospective longitudinal study was conducted among HIV-1 infected individuals aged 21-55 years with CD4+ cell counts ≥ 350cells/µL in fishing villages of North-Western Tanzania. Single stool samples were examined for S. mansoni eggs using Kato Katz technique at 6-month follow-up and 12 weeks after treatment. Venous blood samples were collected at baseline, at three and six-month follow-up and 12 weeks after praziquantel treatment for HIV-1 plasma viral loads and CD4+ cell quantification.Results: Of the 50 HIV-1 infected participants at baseline, 44% (22/50, 95%CI; 30.58-58.35) were found to be co-infected with S. mansoni at 6-month follow-up with a mean of 93.26GM-epg (95%CI: 60.42-143.95). The median CD4+ cell counts did not differ significantly between individuals infected with HIV-1 and those co-infected with HIV-1 and S. mansoni at baseline (P=0.62), 3-month (P=0.64) and 6-month (P=0.41) follow-up. Monthly decrease in CD4+ cells did not differ significantly between the two groups at all follow-up points (-30.39cell/µL versus -31.35cells/µL, P=0.89). Those infected with S. mansoni had a significantly higher mean log10 HIV-1 plasma viral load at baseline (5.98 ± 3.06 versus 9.21 ± 1.91copies/ml, P<0.0001) and 3-month follow-up (8.19 ± 2.17 versus 9.44 ± 1.99copies/ml, P<0.042) compared to those infected with HIV-1 only. This difference was not evident at the time of S. mansoni diagnosis at 6-month time point. Praziquantel treatment in co-infected individuals (n=12) did not result in any change in CD4+ cell counts and mean HIV-1 plasma viral loads (t=-0.9156, P=0.38), comparing baseline and 3-month follow-up after treatment. No correlation was observed between log S. mansoni egg counts and log10 HIV-1 RNA viral loads (r=-0.066, P=0.77) at six-month follow-up in co-infected individuals (n=22).Conclusion: HIV-1 plasma viral loads varied significantly among mono and co-infected individuals at baseline and 3-month follow-up. However, CD4+ cell counts did not vary between the two groups at all follow-up time points. Praziquantel treatment of co-infected individuals did not result in changes in CD4+ cell counts and HIV-1 plasma viral loads.

scholarly journals Risk Factors for Unfavorable Treatment Outcomes among the Human Immunodeficiency Virus-Associated Tuberculosis Population in Tashkent City, Uzbekistan: 2013–2017

2021 ◽  
Vol 18 (9) ◽  
pp. 4623
Author(s):  
Sherali Massavirov ◽  
Kristina Akopyan ◽  
Fazlkhan Abdugapparov ◽  
Ana Ciobanu ◽  
Arax Hovhanessyan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Human Immunodeficiency Virus ◽  
Treatment Outcomes ◽  
Sputum Smear ◽  
People Living With Hiv ◽  
Tb Treatment ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Immunodeficiency Virus ◽  
Positive Sputum Smear

Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection poses a growing clinical challenge. People living with HIV have a higher chance of developing TB, and once the disease has progressed, are at greater risk of having unfavorable TB treatment outcomes. Data on TB treatment outcomes among the HIV-associated TB population in Uzbekistan are limited. Thus, we conducted a cohort study among 808 adult patients with HIV-associated TB registered at the Tashkent TB referral hospital from 2013–2017 to document baseline characteristics and evaluate risk factors for unfavorable TB treatment outcomes. The data were collected from medical records and ambulatory cards. About 79.8% of the study population had favorable treatment outcomes. Antiretroviral therapy (ART) coverage at the admission was 26.9%. Information on CD4-cell counts and viral loads were largely missing. Having extrapulmonary TB (aOR 2.21, 95% CI: 1.38–3.53, p = 0.001), positive sputum smear laboratory results on admission (aOR 1.62, 95% CI: 1.07–2.40), diabetes (aOR 5.16, 95% CI: 1.77–14.98), and hepatitis C (aOR 1.68, 95% CI: 1.14–2.46) were independent risk factors for developing unfavorable TB treatment outcomes. The study findings provide evidence for targeted clinical management in co-infected patients with risk factors. Strengthening the integration of TB/HIV services may improve availability of key data to improve co-infection management.

scholarly journals Predictors of virological failure among people living with HIV receiving first line antiretroviral treatment in Myanmar: retrospective cohort analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anita Mesic ◽  
Alexander Spina ◽  
Htay Thet Mar ◽  
Phone Thit ◽  
Tom Decroo ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Antiretroviral Treatment ◽  
People Living With Hiv ◽  
First Line ◽  
Hiv Viral Load ◽  
Loss To Follow Up ◽  
History Of ◽  
Living With Hiv

Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe the viral load (VL) cascade, the incidence of virological failure and associated risk factors among people living with HIV receiving first-line ART in an HIV cohort in Myanmar treated by the Médecins Sans Frontières in collaboration with the Ministry of Health and Sports Myanmar. Methods We conducted a retrospective cohort study, including adult patients with at least one HIV viral load test result and having received of at least 6 months’ standard first-line ART. The incidence rate of virological failure (HIV viral load ≥ 1000 copies/mL) was calculated. Multivariable Cox’s regression was performed to identify risk factors for virological failure. Results We included 25,260 patients with a median age of 33.1 years (interquartile range, IQR 28.0–39.1) and a median observation time of 5.4 years (IQR 3.7–7.9). Virological failure was documented in 3,579 (14.2%) participants, resulting in an overall incidence rate for failure of 2.5 per 100 person-years of follow-up. Among those who had a follow-up viral load result, 1,258 (57.1%) had confirmed virological failure, of which 836 (66.5%) were switched to second-line treatment. An increased hazard for failure was associated with age ≤ 19 years (adjusted hazard ratio, aHR 1.51; 95% confidence intervals, CI 1.20–1.89; p < 0.001), baseline tuberculosis (aHR 1.39; 95% CI 1.14–1.49; p < 0.001), a history of low-level viremia (aHR 1.60; 95% CI 1.42–1.81; p < 0.001), or a history of loss-to-follow-up (aHR 1.24; 95% CI 1.41–1.52; p = 0.041) and being on the same regimen (aHR 1.37; 95% CI 1.07–1.76; p < 0.001). Cumulative appointment delay was not significantly associated with failure after controlling for covariates. Conclusions VL monitoring is an important tool to improve programme outcomes, however limited coverage of VL testing and acting on test results hampers its full potential. In our cohort children and adolescents, PLHIV with history of loss-to-follow-up or those with low-viremia are at the highest risk of virological failure and might require more frequent virological monitoring than is currently recommended.

Causes and outcomes of hospitalizations among people living with HIV in Georgia’s referral institution, 2012–2017

2021 ◽  
Vol 32 (7) ◽  
pp. 662-670
Author(s):  
Nino Rukhadze ◽  
Ole Kirk ◽  
Nikoloz Chkhartishvili ◽  
Natalia Bolokadze ◽  
Lali Sharvadze ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Clinical Immunology ◽  
Fatal Outcome ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Lethal Outcome ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Living With Hiv ◽  
Cd4 Cell

We assessed trends in causes and outcomes of hospitalization among people living with HIV (PLWH) admitted to the Infectious Diseases, AIDS and Clinical Immunology Research Center (IDACIRC) in Tbilisi, Georgia. Retrospective analysis included adult PLWH admitted to IDACIRC for at least 24 h. Internationally validated categorization was used to split AIDS admissions into mild, moderate, and severe AIDS. A total of 2085 hospitalizations among 1123 PLWH were registered over 2012–2017 with 65.1% (731/1123) of patients presenting with CD4 count <200. Of 2085 hospitalizations, 931 (44.7%) were due to AIDS-defining illnesses. In 2012, AIDS conditions accounted for 50.3% of admissions compared to 41.6% in 2017 ( p = 0.16). Overall, 167 hospitalizations (8.0%) resulted in lethal outcome. AIDS admissions had higher mortality than non-AIDS admissions (11.5% vs 5.2%, p < 0.0001). Among 167 deceased patients, 137 (82.0%) had CD4 count <200 at admission. In multivariate analysis, factors significantly associated with mortality included severe AIDS versus non-AIDS admission (OR 2.81, 95% CI: 1.10–7.15), CD4 cell counts <50 (OR 4.34, 95% CI: 2.52–7.47), and 50–100 (OR 2.37, 95% CI: 1.27–4.42) versus >200. Active AIDS disease remains a significant cause of hospitalization and fatal outcome in Georgia. Earlier diagnosis of HIV is critical for decreasing AIDS hospitalizations and mortality.

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