n Southern African Journal of HIV Medicine - The spectrum and prognosis of AIDS-defining illnesses in Cape Town
|Article Title||The spectrum and prognosis of AIDS-defining illnesses in Cape Town|
|Journal||Southern African Journal of HIV Medicine|
|Author||M. Badri, Gary Maartens, Linda-Gail Bekker and Robin Wood|
|Publication Date||Jun 2005|
|Pages||11 - 16|
<I>Objectives.</I> To describe the incidence, spectrum and prognosis of AIDS-defining illnesses (ADI) in patients without access to antiretroviral therapy (ART). <BR><I>Design.</I> Prospective cohort study. <BR><I>Subjects.</I> 1 215 HIV-infected patients attending adult HIV clinics affiliated to the University of Cape Town in the New Somerset and Groote Schuur Hospitals from 1992 to 2000. <BR><I>Main outcome measures.</I> Incidence rate (IR) of ADIs and survival after the development of ADI. <BR><I>Results.</I> During follow-up, 430 ADIs occurred (IR = 21.3 cases per 100 patient-years (PYs)). IR varied according to CD4 count, with 38.8, 17.0 and 8.52 cases/100 PYs in patients with CD4 counts < 200 cells/µl, 200 - 350 cells/µl and > 350 cells/µl, respectively. Tuberculosis (TB) was the commonest ADI, followed by candidiasis of the oesophagus/trachea/bronchi. IRs for chronic herpes simplex ulcers, HIV wasting, <I>Pneumocystis carinii</I> pneumonia and Kaposi's sarcoma were > 1.00 cases/100 PYs. TB was diagnosed in all CD4 strata, and was the only illness to occur commonly above 200 cells/µl. The median CD4 counts within 6 months of diagnosis of ADI ranged from 138 cells/µl for TB to 17 cells/µl for cryptococcosis. Overall, median time to death from date of diagnosis was 18 months, and ranged from 24.1 months for patients diagnosed with TB to 6 months for those diagnosed with cytomegalovirus. <BR><I>Conclusions.</I> HIV-infected patients with no access to ART in Cape Town are at high risk of AIDS-defining illnesses. This study provides useful data for designing therapeutic interventions for preventing these infections.
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