Journal of the International Association of Providers of AIDS Care (Jul 2013)

Predictors of Clinical Progression in HIV-1-Infected Adults Initiating Combination Antiretroviral Therapy with Advanced Disease in the Asia-Pacific Region

  • H. Byakwaga MBChB, PhD,
  • K. Petoumenos BSc, MA, MPH, PhD,
  • J. Ananworanich MD, PhD,
  • F. Zhang MD,
  • M. A. Boyd MD, FRACP,
  • T. Sirisanthana MD,
  • P. C. K. Li MD, MBBS,
  • C. Lee MD, MBBS,
  • C. V. Mean MD,
  • V. Saphonn MD, PhD,
  • S. F. S. Omar MD, MBBS,
  • S. Pujari MD,
  • P. Phanuphak MD, PhD,
  • P. L. Lim MD, MPH, FAMS,
  • N. Kumarasamy MD, MBBS, PhD,
  • Y. M. A. Chen MD, MS, ScD,
  • T. P. Merati MD, PhD,
  • S. Sungkanuparph MD,
  • R. Ditangco MD,
  • S. Oka MD, PhD,
  • G. Tau MD,
  • J. Zhou BMed, MPH, PhD,
  • M. G. Law MA, MSc, PhD,
  • S. Emery BSc, PhD

DOI
https://doi.org/10.1177/1545109712469684
Journal volume & issue
Vol. 12

Abstract

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The majority of HIV-infected patients in developing countries commences combination antiretroviral therapy (cART) with advanced disease. We examined predictors of disease progression in patients initiating cART with CD4 count ≤200 cells/mm 3 in the TREAT Asia HIV Observational Database. The main outcome measure was progression to either an AIDS-defining illness or death occurring 6 months after initiation of cART. We used survival analysis methods. A total of 1255 patients contributed 2696 person years of follow-up; 73 were diagnosed with AIDS and 9 died. The rate of progression to the combined end point was 3.0 per 100 person years. The factors significantly associated with a higher risk of disease progression were Indian ethnicity, infection through intravenous drug use, lower CD4 count, and hemoglobin ≤130 g/dL at 6 months. In conclusion, measurements of CD4 count and hemoglobin at month 6 may be useful for early identification of disease progression in resource-limited settings.