Weight gain at 3 months of antiretroviral therapy is strongly associated with survival: evidence from two developing countries

Hdl Handle:
http://hdl.handle.net/10144/116979
Title:
Weight gain at 3 months of antiretroviral therapy is strongly associated with survival: evidence from two developing countries
Authors:
Madec, Yoann; Szumilin, Elisabeth; Genevier, Christine; Ferradini, Laurent; Balkan, Suna; Pujades, Mar; Fontanet, Arnaud
Journal:
AIDS (London, England)
Abstract:
BACKGROUND: In developing countries, access to laboratory tests remains limited, and the use of simple tools such as weight to monitor HIV-infected patients treated with antiretroviral therapy should be evaluated. METHODS: Cohort study of 2451 Cambodian and 2618 Kenyan adults who initiated antiretroviral therapy between 2001 and 2007. The prognostic value of weight gain at 3 months of antiretroviral therapy on 3-6 months mortality, and at 6 months on 6-12 months mortality, was investigated using Poisson regression. RESULTS: Mortality rates [95% confidence interval (CI)] between 3 and 6 months of antiretroviral therapy were 9.9 (7.6-12.7) and 13.5 (11.0-16.7) per 100 person-years in Cambodia and Kenya, respectively. At 3 months, among patients with initial body mass index less than or equal to 18.5 kg/m (43% of the study population), mortality rate ratios (95% CI) were 6.3 (3.0-13.1) and 3.4 (1.4-8.3) for those with weight gain less than or equal to 5 and 5-10%, respectively, compared with those with weight gain of more than 10%. At 6 months, weight gain was also predictive of subsequent mortality: mortality rate ratio (95% CI) was 7.3 (4.0-13.3) for those with weight gain less than or equal to 5% compared with those with weight gain of more than 10%. CONCLUSION: Weight gain at 3 months is strongly associated with survival. Poor compliance or undiagnosed opportunistic infections should be investigated in patients with initial body mass index less than or equal to 18.5 and achieving weight gain less than or equal to 10%.
Affiliation:
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France; Medecins Sans Frontieres, Paris, France; Medecins Sans Frontieres, Nairobi, Kenya; Infectious Diseases Department, Khmero-Soviet Friendship Hospital, Phnom Penh, Cambodia; Epicentre, Paris, France
Issue Date:
27-Apr-2009
URI:
http://hdl.handle.net/10144/116979
DOI:
10.1097/QAD.0b013e32832913ee
PubMed ID:
19287299
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed
Type:
Article
Language:
en
ISSN:
1473-5571
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorMadec, Yoannen
dc.contributor.authorSzumilin, Elisabethen
dc.contributor.authorGenevier, Christineen
dc.contributor.authorFerradini, Laurenten
dc.contributor.authorBalkan, Sunaen
dc.contributor.authorPujades, Maren
dc.contributor.authorFontanet, Arnauden
dc.date.accessioned2010-12-02T19:35:06Z-
dc.date.available2010-12-02T19:35:06Z-
dc.date.issued2009-04-27-
dc.identifier.citationAIDS 2009;23(7):853-61en
dc.identifier.issn1473-5571-
dc.identifier.pmid19287299-
dc.identifier.doi10.1097/QAD.0b013e32832913ee-
dc.identifier.urihttp://hdl.handle.net/10144/116979-
dc.description.abstractBACKGROUND: In developing countries, access to laboratory tests remains limited, and the use of simple tools such as weight to monitor HIV-infected patients treated with antiretroviral therapy should be evaluated. METHODS: Cohort study of 2451 Cambodian and 2618 Kenyan adults who initiated antiretroviral therapy between 2001 and 2007. The prognostic value of weight gain at 3 months of antiretroviral therapy on 3-6 months mortality, and at 6 months on 6-12 months mortality, was investigated using Poisson regression. RESULTS: Mortality rates [95% confidence interval (CI)] between 3 and 6 months of antiretroviral therapy were 9.9 (7.6-12.7) and 13.5 (11.0-16.7) per 100 person-years in Cambodia and Kenya, respectively. At 3 months, among patients with initial body mass index less than or equal to 18.5 kg/m (43% of the study population), mortality rate ratios (95% CI) were 6.3 (3.0-13.1) and 3.4 (1.4-8.3) for those with weight gain less than or equal to 5 and 5-10%, respectively, compared with those with weight gain of more than 10%. At 6 months, weight gain was also predictive of subsequent mortality: mortality rate ratio (95% CI) was 7.3 (4.0-13.3) for those with weight gain less than or equal to 5% compared with those with weight gain of more than 10%. CONCLUSION: Weight gain at 3 months is strongly associated with survival. Poor compliance or undiagnosed opportunistic infections should be investigated in patients with initial body mass index less than or equal to 18.5 and achieving weight gain less than or equal to 10%.en
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmeden
dc.rightsPublished by Wolters Kluwer Lippincott Williams & Wilkins - Archived on this site by kind permission Wolters Kluweren
dc.subject.meshAdulten
dc.subject.meshAntiretroviral Therapy, Highly Activeen
dc.subject.meshCD4 Lymphocyte Counten
dc.subject.meshCambodiaen
dc.subject.meshCohort Studiesen
dc.subject.meshFemaleen
dc.subject.meshGenotypeen
dc.subject.meshHIV Infectionsen
dc.subject.meshHIV-1en
dc.subject.meshHumansen
dc.subject.meshImmunocompromised Hosten
dc.subject.meshKenyaen
dc.subject.meshMaleen
dc.subject.meshRNA, Viralen
dc.subject.meshSurvival Analysisen
dc.subject.meshTreatment Outcomeen
dc.subject.meshWeight Gainen
dc.titleWeight gain at 3 months of antiretroviral therapy is strongly associated with survival: evidence from two developing countriesen
dc.typeArticleen
dc.contributor.departmentUnité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France; Medecins Sans Frontieres, Paris, France; Medecins Sans Frontieres, Nairobi, Kenya; Infectious Diseases Department, Khmero-Soviet Friendship Hospital, Phnom Penh, Cambodia; Epicentre, Paris, Franceen
dc.identifier.journalAIDS (London, England)en

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