Early mortality after late initiation of antiretroviral therapy in the TREAT Asia HIV Observational Database (TAHOD) of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia‐Pacific

Objectives Early mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource‐limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with...

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Bibliographic Details
Published in:HIV medicine 2020-07, Vol.21 (6), p.397-402
Main Authors: Rupasinghe, D, Kiertiburanakul, S, Kamarulzaman, A, Zhang, F, Kumarasamy, N, Chaiwarith, R, Merati, TP, Do, CD, Khusuwan, S, Avihingsanon, A, Lee, MP, Ly, PS, Yunihastuti, E, Nguyen, KV, Ditangco, R, Chan, YJ, Pujari, S, Ng, OT, Choi, JY, Sim, BLH, Tanuma, J, Sangle, S, Ross, J, Law, M
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
advanced disease
AIDS
Alanine
Alanine transaminase
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Asia‐Pacific
Body mass
Body mass index
Body size
CD4 antigen
Confidence intervals
Drug therapy
Epidemiology
Fatalities
Health hazards
Health risks
HIV
Human immunodeficiency virus
Inflammation
Mortality
Regression analysis
Risk analysis
Risk factors
Statistical analysis
Survival
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Summary:Objectives Early mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource‐limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with HIV (PLHIV) starting ART at low CD4 levels in the Asia‐Pacific. Methods PLHIV enrolled in the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) who initiated ART with a CD4 count  1 year were censored at 12 months. Competing risk regression was used to analyse risk factors with loss to follow‐up as a competing risk. Results A total of 1813 PLHIV were included in the study, of whom 74% were male. With 73 (4%) deaths, the overall first‐year mortality rate was 4.27 per 100 person‐years (PY). Thirty‐eight deaths (52%) were AIDS‐related, 10 (14%) were immune reconstituted inflammatory syndrome (IRIS)‐related, 13 (18%) were non‐AIDS‐related and 12 (16%) had an unknown cause. Risk factors included having a body mass index (BMI)  50 cell/μL are associated with improved short‐term survival rates, even in those with late stages of HIV disease.
ISSN:1464-2662
1468-1293
DOI:10.1111/hiv.12836