Six-Month Mortality among HIV-Infected Adults Presenting for Antiretroviral Therapy with Unexplained Weight Loss, Chronic Fever or Chronic Diarrhea in Malawi 英文参考文献.docVIP

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Six-Month Mortality among HIV-Infected Adults Presenting for Antiretroviral Therapy with Unexplained Weight Loss, Chronic Fever or Chronic Diarrhea in Malawi 英文参考文献.doc

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Six-Month Mortality among HIV-Infected Adults Presenting for Antiretroviral Therapy with Unexplained Weight Loss, Chronic Fever or Chronic Diarrhea in Malawi 英文参考文献

Six-MonthMortalityamongHIV-InfectedAdults PresentingforAntiretroviralTherapywithUnexplained WeightLoss,ChronicFeverorChronicDiarrheain Malawi MoniquevanLettow1,2*,AnnAkesson? 3,AlexandraL.C.Martiniuk1,2,4,AndrewRamsay5,6 , AdrienneK.Chan1,2,SuzanneT.Anderson7,8,AnthonyD.Harries9,10,ElizabethCorbett7,10 RobertS.Heyderman7,RonyZachariah11,RichardA.Bedell1,12 , 1DignitasInternational,Zomba,Malawi,2UniversityofToronto,Toronto,Canada,3Me′decinsSansFrontie`res, Thyolo,Malawi,4GeorgeInstituteforGlobalHealthand theUniversityofSydney,Sydney,Australia,5WorldHealthOrganization,TropicalDiseaseResearchProgramme,Geneva,Switzerland,6SchoolofMedicine,Universityof StAndrews,Fife,Scotland,7Malawi-Liverpool-WellcomeTrustClinicalResearchProgramme,UniversityofMalawiCollegeofMedicine,Blantyre,Malawi,8Brightonand SussexMedicalSchool,Falmer,UnitedKingdom,9InternationalUnionAgainstTuberculosisandLungDisease,Paris,France,10LondonSchoolofHygieneandTropical Medicine, London, United Kingdom, 11Me′decins Sans Frontie`res, Operational Research Unit, Brussels Operational Centre, Luxembourg, Luxembourg, 12Division of GlobalHealth,UniversityofBritishColumbia,Vancouver,Canada Abstract Background: In sub-Saharan Africa, early mortality is high following initiation of antiretroviral therapy (ART). We investigated 6-month outcomes and factors associated with mortality in HIV-infected adults being assessed for ART initiationandpresentingwithweightloss,chronicfeverordiarrhea,andwithnegativeTBsputummicroscopy. Methods: A prospective cohort study was conducted in Malawi, investigating mortality in relation to ART uptake, microbiologicalfindingsandtreatmentofopportunisticinfection(OIs),6monthsaftermeetingARTeligibilitycriteria. Results:Of469consecutiveadultseligibleforART,74(16%)diedwithin6monthsofenrolment,atamedianof41days(IQR 20–81).370(79%)startedARTatamediantimeof18days(IQR7–40)afterenrolment.Six-monthcase-fatalityrateswere higher in patients with OIs; 25/121(21%) in confirmed/clinical