Introduction The recently published 2010 United Nations (UNGASS) report shows that 70% of adults and children with HIV are alive 12 months after initiation of antiretroviral therapy in Nigeria. This study evaluated survival of patients on therapy towards understanding treatment outcomes.
Methods A retrospective chart review of 446 adult patients who have been on treatment from January 2007 to December 2009 in Lagos and who started triple therapy were included. Information such as CD4 count, opportunistic infections (OI), clinical staging and laboratory parameters was obtained. Cox proportional hazard model was used to determine the correlates of mortality.
Results Median age: 29 years (IQR: 21–56 years); male: 184 (41.3%); female: 262 (58.7%). At baseline, 173 (38.8%) were in WHO stage 3 and 4; 65 (14.6%) had CD4 count >100 cells/mm3 and 264 (59.2%) had at least one OI. Median CD4 count was 216 cells/mm3 (IQR: 154–498 cells/mm3) at median survival time of 26.5 months. Survival probability at 12 months was 62.1% (95% CI 54.4 to 70.2%). Regimen changes were necessary in 66 (14.8%) to another first-line drug 54 (12.1%) and second-line 12 (2.6%). Mortality was predicted by age ≥40 years (HR 2.8, 95% CI 1.7 to 5.6); clinical stage 3and 4 (HR 3.4, 95% CI 2.1 to 4.8); CD4 count <150 cells/mm3 (HR 2.1, 95% CI 1.2 to 4.1; weight ≤50 kg (HR 1.8, 95% CI 1.1 to 8.2); and OI (HR 2.1, 95% CI 1.6 to 9.8). Efavirenz-containing regimen had better survival with (HR 0.6 95% CI 0.4 to 0.9).
Conclusion Younger patients and those on efavirenz regimen do better. Early initiation is crucial to survival. There is therefore a need to scale-up of HIV counselling and testing services as entry point to early treatment.
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