PLoS ONE (Jan 2022)

Clinical similarities and differences between two large HIV cohorts in the United States and Africa.

  • Anne K Monroe,
  • Christina S Polyak,
  • Amanda D Castel,
  • Allahna L Esber,
  • Morgan E Byrne,
  • Jonah Maswai,
  • John Owuoth,
  • Lucas Maganga,
  • Emmanuel Bahemana,
  • Yakubu Adamu,
  • Michael Iroezindu,
  • Hannah Kibuuka,
  • Francis Kiweewa,
  • Alan E Greenberg,
  • Trevor A Crowell,
  • Julie A Ake,
  • DC Cohort Executive Committee and AFRICOS Study Group

DOI
https://doi.org/10.1371/journal.pone.0262204
Journal volume & issue
Vol. 17, no. 4
p. e0262204

Abstract

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BackgroundWashington, DC, and sub-Saharan Africa are both affected by generalized HIV epidemics. However, care for persons living with HIV (PLWH) and clinical outcomes may differ in these geographically and culturally diverse areas. We compared patient and clinical site characteristics among adult persons living with HIV (PLWH) enrolled in two longitudinal HIV cohort studies-the African Cohort Study (AFRICOS) and the DC Cohort.MethodsThe DC Cohort is a clinic-based city-wide longitudinal cohort comprised of PLWH attending 15 HIV clinics in Washington, DC. Patients' socio-demographic characteristics, clinical evaluations, and laboratory data are retrospectively collected from electronic medical records and limited manual chart abstraction. AFRICOS is a prospective observational cohort of PLWH and uninfected volunteers attending 12 select HIV care and treatment facilities in Nigeria, Kenya, Uganda and Tanzania. AFRICOS study participants are a subset of clinic patients who complete protocol-specific visits every 6 months with history and physical examination, questionnaire administration, and blood/sputum collection for ascertainment of HIV outcomes and comorbidities, and neurocognitive and functional assessments. Among participants aged ≥ 18 years, we generated descriptive statistics for demographic and clinical characteristics at enrollment and follow up and compared them using bivariable analyses.ResultsThe study sample included 2,774 AFRICOS and 8,420 DC Cohort participants who enrolled from January 2013 (AFRICOS)/January 2011 (DC Cohort) through March 2018. AFRICOS participants were significantly more likely to be women (58.8% vs 27.1%) and younger (83.3% vs 61.1% aged ConclusionsWith similar viral suppression outcomes, but many differences between our cohorts noted, the combined sample provides unique opportunities to assess and compare HIV care and treatment outcomes in the U.S. and sub-Saharan Africa. Comparing these two cohorts may inform care and treatment practices and may pave the way for future pathophysiologic analyses.