1 / 9

1 Epicentre, Paris, France

Reaching 500 CD4 cells/μL is associated with higher survival after 9 months on ART in sub-Saharan African patients. Maman D 1,2 , Pujades-Rodr íguez M 1 , McGuire M 1 ,Nicholas S 1 , Ecochard R 2 , Etard JF 1. 1 Epicentre, Paris, France

katina
Download Presentation

1 Epicentre, Paris, France

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Reaching 500 CD4 cells/μL is associated with higher survival after 9 months on ART in sub-Saharan African patients Maman D1,2, Pujades-Rodríguez M1, McGuire M1,Nicholas S1, Ecochard R2, Etard JF1 1 Epicentre, Paris, France ² Hospices Civils de Lyon, Department of biostatistics, Lyon, France

  2. Study objectives • To explore factors associated with long term mortality (after the first 9 months of ART) • To determine the CD4 level duringtreatment associated with better survival

  3. Methods • 4 HIV programmes supported by MSF • Routine monitoring data (FUCHIA) • Inclusion criteria :Initiated ART btw 2001 & 2010, >15yo, ART naïve & followed-up for at least 9 months • Statistics: Survival analysis using mixed Poisson models

  4. Results: Patients baseline characteristics • 27,108 patients • (71,115.1 PY at risk) • Median time of follow-up: • 3.04 years [IQR 1.75 – 4.76] • Outcomes • Alive at end of follow-up • 23,300 (86.3%) • Deaths • 922 (3.4%) • Lost to follow-up • 2,796 (10.3%)

  5. Results Association between current CD4 counts and mortality after 9 months on ART, Kenya, Malawi and Uganda, 2001-2010, 77,970 CD4 values *Also adjusted by Age, Programmes, Adherence, Years of ART start, Baseline WHO stage, CD4 level and BMI

  6. Discussion • Reaching a CD4 count >500 cells/µL on ART is associated with increased survival. • Indirectly supports policies for earlier initiation of ART as patients would spend less time below 500 CD4 • Cause: More opportunistic infections below 500 CD4 cells/µL

  7. Operational implications • Starting patients earlier is feasible: • In 2008, 40% of new patients not eligible for ART (1/3 of them Lost to Follow-up within a year) • Starting patients earlier will eventually decrease the workload • A cohort= ART + pre-ART patients • After catch-up phase, same number of patients initiated

  8. Acknowledgements • Patients and their family • MSF and MOH staff • MSF medical department & desks • Epicentre, FUCHIA team • Biostatistiques unit: Hospices Civils de Lyon • Sidaction (grant BI20-3-01644)

  9. Thank you !!!

More Related