Age-related comorbidities and mortality in people living with HIV in rural Tanzania

Albrecht, Sascha and Franzeck, Fabian C. and Mapesi, Herry and Hatz, Christoph and Kalinjuma, Aneth Vedastus and Glass, Tracy R. and Mnzava, Dorcas and Letang, Emili and Paris, Daniel H. and Battegay, Manuel and Weisser, Maja and Kiularco Study Group, . (2019) Age-related comorbidities and mortality in people living with HIV in rural Tanzania. AIDS, 33 (6). pp. 1031-1041.

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Official URL: https://edoc.unibas.ch/71943/

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Causes of morbidity and mortality of people living with HIV are changing with access to antiretroviral therapy and increased life expectancy. Age-related data on comorbidities and their impact on mortality in sub-Saharan Africa are scarce.; This prospective analysis evaluated comorbidities, assessed by means of International Classification of Diseases and Related Health problems 10th revision codes and clinical variables, derived from data collected from the Kilombero & Ulanga antiretroviral cohort of people living with HIV in rural Tanzania.; We calculated prevalences and incidences of comorbidities in patients enrolled from 2013 to 2017 and evaluated their association with a combined endpoint of death and loss to follow-up (LTFU) in various age groups (15-29, 30-49 and ≥50 years) using Cox regression analysis.; Of 1622 patients [65% females, median age 38 years (interquartile range 31-46)], 11% were at least 50 years. During a median follow-up of 22.1 months (interquartile range 10.6-37.3), 48 (2.9%) patients died and 306 (18.9%) were LTFU. Anaemia was the most prevalent comorbidity (66.3%) irrespective of age and was associated with increased mortality/LTFU [hazard ratios 2.02 (95% confidence interval (CI) 1.57-2.60); P < 0.001]. In patients aged at least 50 years, arterial hypertension was highly prevalent (43.8%), but not associated with mortality/LTFU [hazard ratios 1.04 (95% CI 0.56-1.93), P = 0.9]. Undernutrition ranged from 25.5% in the youngest to 29.1% in the oldest age group and contributed to mortality/LTFU [hazard ratios 2.24 (95% CI 1.65-3.04); P < 0.001]. Prevalence of tuberculosis was 21.4% with hazard ratios of 2.54 (95% CI 1.72-3.75, P < 0.001) for mortality/LTFU.; We show that anaemia, arterial hypertension and undernutrition are the most relevant comorbidities with different age-associated frequencies and impact on death/LTFU in this population.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED)
UniBasel Contributors:Mapesi, Herry and Hatz, Christoph and Glass, Tracy and Letang Jimenez de Anta, Emilio Angel and Paris, Daniel Henry and Weisser, Maja
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Lippincott, Williams & Wilkins
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:17 Sep 2019 12:34
Deposited On:17 Sep 2019 12:34

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