1. Mortality and morbidity among HIV type-1-infected patients during the first 5 years of a multicountry HIV workplace programme in Africa.
- Author
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Van der Borght SF, Clevenbergh P, Rijckborst H, Nsalou P, Onyia N, Lange JM, de Wit TF, and Van der Loeff MF
- Subjects
- Acquired Immunodeficiency Syndrome immunology, Adolescent, Adult, Africa South of the Sahara epidemiology, Age Factors, Aged, CD4 Lymphocyte Count, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Morbidity, Pregnancy, Sex Factors, Treatment Outcome, Acquired Immunodeficiency Syndrome epidemiology, Acquired Immunodeficiency Syndrome therapy, Antiretroviral Therapy, Highly Active mortality, HIV-1 immunology, Health Benefit Plans, Employee
- Abstract
Background: This study aimed to evaluate the effectiveness of an HIV workplace programme in sub-Saharan Africa., Methods: The international brewing company, Heineken, introduced an HIV workplace programme in its African subsidiaries in 2001. Beneficiaries from 16 sites in 5 countries were eligible. HIV type-1 (HIV-1)-infected individuals were assessed clinically and immunologically, and started highly active antiretroviral therapy (HAART) if they had AIDS or had a CD4+ T-cell count <300 cells/microl. In this cohort, study patients were followed-up for vital status, new AIDS events, CD4+ T-cell count and haemoglobin., Results: Over the first 5 years of the programme, 431 adults were found to be HIV-1-infected. The mortality rate among those not yet taking HAART was 2.6 per 100 person-years of observation (pyo). By October 2006, 249 patients had started HAART at a median CD4+ T-cell count of 170 cells/microl; 59 (23.7%) patients were in CDC stage C. Among patients on HAART, 25 died and 7 were lost to follow-up. The mortality rate was 3.7 per 100 pyo overall, 14 per 100 pyo in the first 16 weeks and 2.5 per 100 pyo thereafter (P < 0.0001). At 4 years after start of treatment, 89% of patients were known to be alive. The CD4+ T-cell count increased by a median of 153 and 238 cells/microl after 1 and 4 years of HAART, respectively., Conclusions: In this HIV workplace programme in sub-Saharan Africa, long-term high survival was achieved.
- Published
- 2009