HIV progression and predictors of mortality in a community-based cohort of Zambian adults

J Int Assoc Physicians AIDS Care (Chic). 2008 Jan-Feb;7(1):17-26. doi: 10.1177/1545109707303989. Epub 2007 Nov 7.

Abstract

This article describes immunological HIV progression, mortality, and its predictors in 974 Zambian adults. During 3138 person-years of follow-up, 281 deaths occurred, and the overall mortality rate was 9.0 per 100 person-years. Thirty-six percent of patients were dead within 5 years of enrollment. The median survival in patients with baseline CD4 count ≥500 cells/mm³ was 5.62 years, with CD4 count between 200 and 499 cells/mm³ 5.46 years, and with CD4 count <200 cells/mm³ 3.89 years. The mortality rate increased significantly with older age (6.9 in patients <25 years, 9.3 in individuals aged 25-39 years, 10.2 in patients ≥40 years) and was higher in women (rate ratio 1.29). The median annual change of progression markers was -29.6 cells/mm³ for CD4 count, -3.0% for CD4 count percentage, 1.2 nmol/L for neopterin, -1.9 g/L for hemoglobin, and -70 cells/mm³ for total lymphocyte count. Hemoglobin and neopterin were as accurate as CD4 count to predict mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Anemia / blood
  • Biomarkers
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Disease Progression*
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / immunology*
  • HIV Infections / mortality*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Neopterin / blood
  • Prognosis
  • Sex Distribution
  • Zambia / epidemiology

Substances

  • Biomarkers
  • Neopterin