scholarly journals Factors Affecting Virological Outcome When First-Line Antiretroviral Therapy Is Reintroduced After Unplanned Interruption

2020 ◽  
Vol 19 ◽  
pp. 232595821989953
Author(s):  
Suzy Maria ◽  
Evy Yunihastuti ◽  
Siti Rizny F. Saldi ◽  
Zubairi Djoerban
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Adjusted Odds Ratio ◽  
First Line ◽  
Factors Affecting ◽  
Virological Success ◽  
Virological Outcome ◽  
History Of

There is no guideline concerning choice of antiretroviral therapy (ART) for HIV-infected patients after unplanned interruption. We conducted a retrospective cohort study of HIV-infected patients reintroduced to first-line ART after having unplanned interruption for at least 1 month. Viral load was evaluated at 6 to 18 months after the reintroduction. There were 100 patients included in our study, and 55 of them achieved virological success. History of single interruption (adjusted odds ratio [aOR] 5.51%, 95% confidence interval [CI] 1.82-16.68, P = .003) and CD4 count ≥200 cell/mm3 at the time of reintroduction (aOR 4.33, 95% CI 1.14-16.39, P = .031) increased likelihood to achieve virological success.

scholarly journals Survival and prognostic factors in HIV-infected adults treated with Antiretroviral Therapy in a Malaysian referral hospital: A retrospective cohort study

2019 ◽  
Author(s):  
Lee Sing Chet ◽  
Siti Azrin Ab Hamid ◽  
Norsa'adah Bachok ◽  
Suresh Kumar Chidambaram
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Antiretroviral Therapy ◽  
Haemoglobin Level ◽  
Retrospective Cohort ◽  
Survival Rates ◽  
Baseline Haemoglobin ◽  
History Of ◽  
Overall Survival Rates

Abstract Background: It is well established that antiretroviral therapy (ART) is beneficial in reducing the mortality among patients with human immunodeficiency virus (HIV). In Malaysia, there is lack of study and information regarding the overall survival rates and prognostic factors for survival in HIV-infected adults treated with ART. Therefore, this study aimed to assess and compare the survival rates as well as to identify the prognostic factors for survival among HIV adults in Malaysia.Methods: A retrospective cohort study was conducted by reviewing the medical records of HIV patients who started ART between year 2007 and 2016 at a tertiary referral hospital in Malaysia. ART-naive adults aged 15 years and above were included and those who were transferred out were excluded. After applying inclusion and exclusion criteria, there were 339 cases eligible in this study. Systematic sampling method was applied. Kaplan Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.Results: The estimated overall survival rates were 95.9%, 93.8%, 90.4%, 84.9%, and 72.8% at 6 months, 1 year, 3 years, 5 years and 10 years, respectively. The overall survival rates were significantly different according to age group (p<0.001), employment status (p<0.001), transmission mode (p=0.003), and history of illicit drug use (p=0.017), baseline CD4 cell count (p<0.001), baseline haemoglobin level (p<0.001), tuberculosis co-infection (p<0.001), hepatitis co-infection (p=0.008), first NRTI (p<0.001) and history of defaults (p=0.021). Based on multiple Cox regression, patients who were anaemic had 3.76 times (95% CI: 1.97, 7.18; p<0.001) higher hazard of death than their non-anaemic counterparts. The hazard risk was 2.09 times (95% CI: 1.10, 3.96; p=0.024) higher among HIV patients co-infected with tuberculosis compared to those who were not. Conclusion: Overall survival rates were higher than low-income countries but lower than in high-income countries, and comparable with middle-income countries. Low baseline haemoglobin level and tuberculosis co-infection were strong prognostic factors for HIV survival

scholarly journals Risk Factors for Umbilical Cord Prolapse at the Time of Artificial Rupture of Membranes

2018 ◽  
Vol 08 (02) ◽  
pp. e89-e94 ◽  
Author(s):  
Tetsuya Kawakita ◽  
Chun-Chih Huang ◽  
Helain Landy
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Adjusted Odds Ratio ◽  
Cervical Dilation ◽  
Cord Prolapse ◽  
Umbilical Cord Prolapse ◽  
Singleton Pregnancies

Objective The aim of the study was to examine the association between cervical exam at the time of artificial rupture of membranes (AROM) and cord prolapse. Study Design We conducted a retrospective cohort study using the data from the Consortium on Safe Labor. We included women with cephalic presentation and singleton pregnancies at ≥ 23 weeks' gestation who underwent AROM during the course of labor. Multivariable logistic regression was used to calculate the adjusted odds ratio (aOR) with 95% confidence interval (95% CI), controlling for prespecified covariates. Results Of 57,204 women who underwent AROM, cord prolapse occurred in 113 (0.2%). Compared with dilation 6 to 10 cm + station ≥ 0 at the time of AROM, <6 cm + any station and 6–10 cm + station ≤ −3 were associated with increased risks of cord prolapse (<6 cm + station ≤ −3 [aOR, 2.29; 95% CI, 1.02–5.40]; <6 cm + station −2.5 to −0.5 [aOR, 2.34; 95% CI, 1.23–4.97]; <6 cm + station ≥ 0 [aOR, 3.31; 95% CI, 1.39–8.09]; and 6–10 cm + station ≤ −3 [aOR, 5.47; 95% CI, 1.35–17.48]). Conclusion Cervical dilation < 6 cm with any station and 6 to 10 cm with station ≤ −3 were associated with a higher risk of cord prolapse.

scholarly journals Predictors of Loss to Follow-Up among HIV-Infected Adults after Initiation of the First-Line Antiretroviral Therapy at Arba Minch General Hospital, Southern Ethiopia: A 5-Year Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Mathewos Alemu Gebremichael ◽  
Mekdes Kondale Gurara ◽  
Haymanot Nigussie Weldehawaryat ◽  
Melkamu Merid Mengesha ◽  
Dessalegn Ajema Berbada
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
General Hospital ◽  
Retrospective Cohort Study ◽  
Survival Probability ◽  
Retrospective Cohort ◽  
First Line ◽  
Loss To Follow Up ◽  
Cumulative Survival

Background. Loss to follow-up (LTFU) from antiretroviral therapy (ART) reduces treatment benefits and leads to treatment failure. Hence, this study was aimed at determining the incidence of loss to follow-up and predictors among HIV-infected adults who began first-line antiretroviral therapy at Arba Minch General Hospital. Methods. We carried out an institutional-based retrospective cohort study, and data were collected from the charts of 508 patients who were selected using a simple random sampling technique. All the data management and statistical analyses were conducted using STATA version 14. Cumulative survival probability was estimated and presented in the life table, and the Kaplan-Meir survival curves were compared using the log-rank test. The Cox proportional hazard model was used to identify the independent predictors. Results. We followed 508 patients for 871.9 person-years. A total of 46 (9.1%) experienced loss to follow-up, yielding an overall incidence rate of 5.3 (95% CI: 3.9-7.1) per 100 person-years. The cumulative survival probability was 90%, 88%, 86%, and 86% at the end of one, two, three, and four years, respectively. The predictors identified were age less than 35 years (adjusted hazard ratio ( aHR = 1.96 ; 95% CI: 1.92-4.00)), rural residence ( aHR = 1.98 ; 95% CI: 1.02-3.83), baseline body weight greater than 60 kilograms ( aHR = 2.19 ; 95% CI: 1.11-4.37), a fair level of adherence ( aHR = 11.5 ; 95% CI: 2.10-61.10), and a poor level of adherence ( aHR = 12.03 ; 95% CI: 5.4-26.7). Conclusions. In this study, the incidence rate of loss to follow-up was low. Younger adults below the age of 35 years, living in rural areas, with a baseline weight greater than 60 kilograms, which had a fair and poor adherence level were more likely to be lost from treatment. Therefore, health professionals working in ART clinics and potential stakeholders in HIV/AIDS care and treatment should consider adult patients with these characteristics to prevent LTFU.

Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study

2015 ◽  
Vol 27 (2) ◽  
pp. 118-126 ◽  
Author(s):  
Federico Angriman ◽  
Waldo H Belloso ◽  
Juan Sierra-Madero ◽  
Jorge Sánchez ◽  
Ronaldo Ismerio Moreira ◽  
...  
Keyword(s):  
Latin America ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
First Line

scholarly journals Modeling Outcomes of First-Line Antiretroviral Therapy and Rate of CD4 Counts Change among a Cohort of HIV/AIDS Patients in Ethiopia: A Retrospective Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168323 ◽  
Author(s):  
Tadesse Awoke ◽  
Alemayehu Worku ◽  
Yigzaw Kebede ◽  
Adetayo Kasim ◽  
Belay Birlie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
First Line ◽  
Aids Patients ◽  
Cd4 Counts ◽  
Hiv Aids

scholarly journals The elderly age criterion for increased in-hospital mortality in trauma patients: a retrospective cohort study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Ji Hwan Lee ◽  
Min Joung Kim ◽  
Ju Young Hong ◽  
Jinwoo Myung ◽  
Yun Ho Roh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Adjusted Odds Ratio ◽  
The Elderly ◽  
Trauma Patients ◽  
Elderly Age ◽  
Traumatic Injuries

Abstract Background With an aging population, the number of elderly individuals exposed to traumatic injuries is increasing. The elderly age criterion for traumatic injuries has been inconsistent in the literature. This study aimed at specifying the elderly age criterion when the traumatic mortality rate increases. Methods This is a multicenter retrospective cohort study that was conducted utilizing the data from the Emergency Department-based Injury In-depth Surveillance Registry of the Korea Disease Control and Prevention Agency, collected between January 2014 and December 2018 from 23 emergency departments. The outcome variable was in-hospital mortality. Multivariable logistic regression analysis was used to calculate the adjusted mortality rate for each age group. By using the shape-restricted regression splines method, the relationship between age and adjusted traumatic mortality was plotted and the point where the gradient of the graph had the greatest variation was calculated. Results A total of 637,491 adult trauma patients were included. The number of in-hospital deaths was 6504 (1.0%). The age at which mortality increased the most was 65.06 years old. The adjusted odds ratio for the in-hospital mortality rate with age in the ≤ 64-year-old subgroup was 1.038 (95% confidence interval (CI) 1.032–1.044) and in the ≥ 65-year-old subgroup was 1.059 (95% CI 1.050–1.068). The adjusted odds ratio for in-hospital mortality in the ≥ 65-year-old compared to the ≤ 64-year-old subgroup was 4.585 (95% CI 4.158–5.055, p < 0.001). Conclusions This study found that the in-hospital mortality rate rose with increasing age and that the increase was the most rapid from the age of 65 years. We propose to define the elderly age criterion for traumatic injuries as ≥ 65 years of age.

scholarly journals Causes of Hospitalization and Death among Newly Diagnosed HIV-Infected Adults in Thailand

2020 ◽  
Vol 19 ◽  
pp. 232595822091926
Author(s):  
Sukonthip Chanto ◽  
Sasisopin Kiertiburanakul
Keyword(s):  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Opportunistic Infections ◽  
Length Of Hospital Stay ◽  
Cd4 Count ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Newly Diagnosed ◽  
Therapy Initiation

More than half of newly diagnosed HIV-infected patients enter to care with a low CD4 count. A retrospective cohort study was conducted among newly diagnosed HIV-infected adults who were hospitalized. Of 148 patients, median (interquartile range [IQR]) age was 39.3 (30.5-47.1) years and 114 (77%) patients were male. Baseline median (IQR) CD4 count was 79 (24-218) cells/mm3. The median (IQR) length of hospital stay was 8 (4-16) days. Half of the patients were hospitalized with AIDS-defining illness (ADI). Common opportunistic infections were Pneumocystis jirovecii pneumonia (20.3%) and tuberculosis (18.9%). CD4 count was statistically significantly associated with hospitalization with ADI (odds ratio: 0.85, per 10 cells/mm3 increased; 95% confidence interval: 0.80-0.90). The mortality was 5.4%. In conclusion, half of newly diagnosed Thai HIV-infected patients were hospitalized with ADI. Early detection of HIV infection leading to early antiretroviral therapy initiation and prevention of serious complications is essential.

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