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Effect of sex and age on outcomes among hiv-2 infected patients starting antiretroviral therapy in west africa: a multicentre cohort study.

Effect of sex and age on outcomes among hiv-2 infected patients starting antiretroviral therapy in west africa: a multicentre cohort study.
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Tchounga BK, Hnge BL, Eholie SP, Coffie PA, Jespersen S, Wejse C, Dabis F, Gottlieb GS, Ekouevi DK, ,


Tchounga BK, Hnge BL, Eholie SP, Coffie PA, Jespersen S, Wejse C, Dabis F, Gottlieb GS, Ekouevi DK, , (click to view)

Tchounga BK, Hnge BL, Eholie SP, Coffie PA, Jespersen S, Wejse C, Dabis F, Gottlieb GS, Ekouevi DK, ,

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AIDS (London, England) 2016 8 17()

Abstract
OBJECTIVES
HIV-2-infected individuals usually initiate antiretroviral therapy (ART) at an advanced age compared with HIV-1 patients, with a potential impact on treatment outcomes. This study aimed to investigate the effect of sex and age on mortality and loss to follow-up (LTFU) among HIV-2-infected individuals initiating ART.

METHODS
Analyses were conducted using the database of the IeDEA-HIV-2 West Africa collaboration. LTFU was considered if the interval between the last visit and the closing date for this analysis was >180 days. Probability of death and LTFU were estimated with Kaplan-Meier methods. A Cox regression model was used to identify factors associated with death and LTFU over the first 24 months on ART.

RESULTS
A total of 1,825 HIV-2-infected individuals including 60% women were considered for this analysis. The median age, baseline CD4 and follow-up duration were 45 years (IQR[38-52]), 185 cells/mm (IQR[95-297]) and 28.8 months (IQR[9.8-58.9]), respectively. Over the first 24 months, the mortality rate was 5.2 per100 pyo (95%CI[4.4-6.1]) and 469 (25.7%) were LTFU. Male sex (HR = 1.9; 95%CI[1.4;2.8]), baseline CD4 < 100 cell/mm (HR = 4.4 95%CI[1.7;11.1]; ref≥350 cell/mm), haemoglobin 7.5-10 g/dL (HR = 2.4 95%CI[1.3;4.4]; ref≥12 g/dL); and body mass index <18 kg/m (HR = 2.1 95%CI[1.3;3.4]; ref = 18-25 kg/m) were associated with higher mortality over the first 24 months. Similar associations were found for LTFU. CONCLUSION
Mortality and LTFU are high among ART-receiving HIV-2-infected individuals and higher in men than in women. There is a critical need to further determine the causes of poor retention and implement sex specific solutions that improve outcomes in HIV-2 ART programs.

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