Survival of HIV-infected adolescents on antiretroviral therapy in Uganda : findings from a nationally representative cohort in Uganda

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dc.contributor.authorBakanda, Celestinen_ZA
dc.contributor.authorBirungi, Josephineen_ZA
dc.contributor.authorMwesigwa, Roberten_ZA
dc.contributor.authorNachega, Jean B.en_ZA
dc.contributor.authorChan, Keithen_ZA
dc.contributor.authorPalmer, Alexisen_ZA
dc.contributor.authorFord, Nathanen_ZA
dc.contributor.authorMills, Edward J.en_ZA
dc.date.accessioned2011-06-02T13:25:59Z
dc.date.available2011-06-02T13:25:59Z
dc.date.issued2011-04-29
dc.descriptionCITATION: Bakanda, C. et al. 2011. Survival of HIV-infected adolescents on antiretroviral therapy in Uganda : findings from a nationally representative cohort in Uganda. PLoS ONE, 6(4): e19261, doi:10.1371/journal.pone.0019261.
dc.descriptionThe original publication is available at http://journals.plos.org/plosone
dc.description.abstractBackground: Adolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes for adolescents on cART in resource-limited settings remain scarce. Methods: We developed an observational study of patients who started cART at The AIDS Service Organization (TASO) in Uganda between 2004 and 2009. Age was stratified into three groups: children (≤10 years), adolescents (11-19 years), and adults (≥20 years). Kaplan-Meier survival curves were generated to describe time to mortality and loss to follow-up, and Cox regression used to model associations between age and mortality and loss to follow-up. To address loss to follow up, we applied a weighted analysis that assumes 50% of lost patients had died. Findings: A total of 23,367 patients were included in this analysis, including 810 (3.5%) children, 575 (2.5%) adolescents, and 21 982 (94.0%) adults. A lower percentage of children (5.4%) died during their cART treatment compared to adolescents (8.5%) and adults (10%). After adjusting for confounding, other features predicted mortality than age alone. Mortality was higher among males (p<0.001), patients with a low initial CD4 cell count (p<0.001), patients with advanced WHO clinical disease stage (p<0.001), and shorter duration of time receiving cART (p<0.001). The crude mortality rate was lower for children (22.8 per 1000 person-years; 95% CI: 16.1, 29.5), than adolescents (36.5 per 1000 person-years; 95% CI: 26.3, 46.8) and adults (37.5 per 1000 person-years; 95% CI: 35.9, 39.1). Interpretation: This study is the largest assessment of adolescents receiving cART in Africa. Adolescents did not have cART mortality outcomes different from adults or children. © 2011 Bakanda et al.
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0019261
dc.description.versionPublisher's version
dc.format.extent6 pages
dc.identifier.citationBakanda, C. et al. 2011. Survival of HIV-infected adolescents on antiretroviral therapy in Uganda : findings from a nationally representative cohort in Uganda. PLoS ONE, 6(4): e19261, doi:10.1371/journal.pone.0019261.
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0019261
dc.identifier.urihttp://hdl.handle.net/10019.1/14864
dc.language.isoen
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyright
dc.subjectHIV infections -- Ugandaen_ZA
dc.titleSurvival of HIV-infected adolescents on antiretroviral therapy in Uganda : findings from a nationally representative cohort in Ugandaen_ZA
dc.typeArticle
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