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Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi: a retrospective cohort analysis

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Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi : a retrospective cohort analysis. / Singogo, Emmanuel; Keegan, Thomas J; Diggle, Peter J; van Lettow, Monique; Matengeni, Alfred; van Oosterhout, Joep J; Sodhi, Sumeet; Joshua, Martias; Taylor, Benjamin M.

In: International Health, Vol. 9, No. 5, 09.2017, p. 281-287.

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Singogo, Emmanuel ; Keegan, Thomas J ; Diggle, Peter J ; van Lettow, Monique ; Matengeni, Alfred ; van Oosterhout, Joep J ; Sodhi, Sumeet ; Joshua, Martias ; Taylor, Benjamin M. / Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi : a retrospective cohort analysis. In: International Health. 2017 ; Vol. 9, No. 5. pp. 281-287.

Bibtex

@article{b8cf6a76cafa453d89c47d2cf5990add,
title = "Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi: a retrospective cohort analysis",
abstract = "Background: The HIV epidemic is a major public health concern throughout Africa. Malawi is one of the worst affected countries in sub-Saharan Africa with a 2014 national HIV prevalence currently estimated at 10{\%} (9.3-10.8{\%}) by UNAIDS. Study reports, largely in the African setting comparing outcomes in HIV patients with and without Kaposi's sarcoma (KS) indicate poor prognosis and poor health outcomes amongst HIV+KS patients. Understanding the mortality risk in this patient group could help improve patient management and care.Methods: Using data for the 559 adult HIV+KS patients who started ART between 2004 and September 2011 at Zomba clinic in Malawi, we estimated relative hazard ratios for all-cause mortality by controlling for age, sex, TB status, occupation, date of starting treatment and distance to the HIV+KS clinic.Results: Patients with tuberculosis (95{\%} CI: 1.05-4.65) and patients who started ART before 2008 (95{\%} CI: 0.34-0.81) were at significantly greater risk of dying. A random-effects Cox model with Log-Gaussian frailties adequately described the variation in the hazard for mortality.Conclusion: The year of starting ART and TB status significantly affected survival among HIV+KS patients. A sub-population analysis of this kind can inform an efficient triage system for managing vulnerable patients.",
keywords = "Adolescent, Adult, Female, HIV Infections, Humans, Malawi, Male, Middle Aged, Retrospective Studies, Sarcoma, Kaposi, Survival Analysis, Young Adult, Journal Article",
author = "Emmanuel Singogo and Keegan, {Thomas J} and Diggle, {Peter J} and {van Lettow}, Monique and Alfred Matengeni and {van Oosterhout}, {Joep J} and Sumeet Sodhi and Martias Joshua and Taylor, {Benjamin M}",
year = "2017",
month = "9",
doi = "10.1093/inthealth/ihx027",
language = "English",
volume = "9",
pages = "281--287",
journal = "International Health",
issn = "1876-3413",
publisher = "Elsevier Limited",
number = "5",

}

RIS

TY - JOUR

T1 - Differences in survival among adults with HIV-associated Kaposi's sarcoma during routine HIV treatment initiation in Zomba district, Malawi

T2 - a retrospective cohort analysis

AU - Singogo, Emmanuel

AU - Keegan, Thomas J

AU - Diggle, Peter J

AU - van Lettow, Monique

AU - Matengeni, Alfred

AU - van Oosterhout, Joep J

AU - Sodhi, Sumeet

AU - Joshua, Martias

AU - Taylor, Benjamin M

PY - 2017/9

Y1 - 2017/9

N2 - Background: The HIV epidemic is a major public health concern throughout Africa. Malawi is one of the worst affected countries in sub-Saharan Africa with a 2014 national HIV prevalence currently estimated at 10% (9.3-10.8%) by UNAIDS. Study reports, largely in the African setting comparing outcomes in HIV patients with and without Kaposi's sarcoma (KS) indicate poor prognosis and poor health outcomes amongst HIV+KS patients. Understanding the mortality risk in this patient group could help improve patient management and care.Methods: Using data for the 559 adult HIV+KS patients who started ART between 2004 and September 2011 at Zomba clinic in Malawi, we estimated relative hazard ratios for all-cause mortality by controlling for age, sex, TB status, occupation, date of starting treatment and distance to the HIV+KS clinic.Results: Patients with tuberculosis (95% CI: 1.05-4.65) and patients who started ART before 2008 (95% CI: 0.34-0.81) were at significantly greater risk of dying. A random-effects Cox model with Log-Gaussian frailties adequately described the variation in the hazard for mortality.Conclusion: The year of starting ART and TB status significantly affected survival among HIV+KS patients. A sub-population analysis of this kind can inform an efficient triage system for managing vulnerable patients.

AB - Background: The HIV epidemic is a major public health concern throughout Africa. Malawi is one of the worst affected countries in sub-Saharan Africa with a 2014 national HIV prevalence currently estimated at 10% (9.3-10.8%) by UNAIDS. Study reports, largely in the African setting comparing outcomes in HIV patients with and without Kaposi's sarcoma (KS) indicate poor prognosis and poor health outcomes amongst HIV+KS patients. Understanding the mortality risk in this patient group could help improve patient management and care.Methods: Using data for the 559 adult HIV+KS patients who started ART between 2004 and September 2011 at Zomba clinic in Malawi, we estimated relative hazard ratios for all-cause mortality by controlling for age, sex, TB status, occupation, date of starting treatment and distance to the HIV+KS clinic.Results: Patients with tuberculosis (95% CI: 1.05-4.65) and patients who started ART before 2008 (95% CI: 0.34-0.81) were at significantly greater risk of dying. A random-effects Cox model with Log-Gaussian frailties adequately described the variation in the hazard for mortality.Conclusion: The year of starting ART and TB status significantly affected survival among HIV+KS patients. A sub-population analysis of this kind can inform an efficient triage system for managing vulnerable patients.

KW - Adolescent

KW - Adult

KW - Female

KW - HIV Infections

KW - Humans

KW - Malawi

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Sarcoma, Kaposi

KW - Survival Analysis

KW - Young Adult

KW - Journal Article

U2 - 10.1093/inthealth/ihx027

DO - 10.1093/inthealth/ihx027

M3 - Journal article

VL - 9

SP - 281

EP - 287

JO - International Health

JF - International Health

SN - 1876-3413

IS - 5

ER -