Faculty Opinions recommendation of Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries.

Publisher Website
Google Scholar
Abstract
Patients starting highly active antiretroviral therapy (HAART) in resource-poor settings have an increased mortality, particularly in the early months of treatment, compared with patients in developed countries; timely diagnosis and assessment of eligibility for treatment, and free provision of antiretroviral drugs might reduce this excess mortality. ART is being scaled up in developing countries, and anecdotal evidence coupled with country reports have pointed to an excess mortality, especially during the early months of treatment. A large comparative study from 18 ART programmes in Africa, Asia and South America and 12 HIV cohort studies from Europe and North America provided data from 4810 and 22,217 treatment-naive adults starting ART, respectively. Mortality was higher in low-income settings than in high-income settings, particularly in the early months of treatment where the adjusted hazard ratio for mortality between low- and high-income settings was 4.3 during the first month. This dropped to 1.5 during months 7-12. It is suggested that earlier diagnosis and treatment of advanced HIV disease, including tuberculosis, invasive bacterial and fungal infections, plus free antiretroviral drugs might result in a lower mortality.

This publication has 0 references indexed in Scilit: