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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Differences in HIV natural history among African and non-African seroconverters in Europe and seroconverters in Sub-Saharan Africa
PLoS ONE, Volume 7, No. 3, Article e32369, Year 2012
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Description
Introduction: It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations. Methods: We estimated CD4 cell loss in ART-naïve, AIDS-free individuals using mixed models allowing for random intercept and slope, and time from seroconversion to clinical AIDS, death and antiretroviral therapy (ART) initiation by survival methods. Using CASCADE data from 20 European and 3 sub-Saharan African (SSA) cohorts of heterosexually-infected individuals, aged ≥15 years, infected ≥2000, we compared estimates between non-African Europeans, Africans in Europe, and Africans in SSA. Results: Of 1,959 (913 non-Africans, 302 Europeans - African origin, 744 SSA), two-thirds were female; median age at seroconversion was 31 years. Individuals in SSA progressed faster to clinical AIDS but not to death or non-TB AIDS. They also initiated ART later than Europeans and at lower CD4 cell counts. In adjusted models, Africans (especially from Europe) had lower CD4 counts at seroconversion and slower CD4 decline than non-African Europeans. Median (95% CI) CD4 count at seroconversion for a 15-29 year old woman was 607 (588-627) (non-African European), 469 (442-497) (European - African origin) and 570 (551-589) (SSA) cells/μL with respective CD4 decline during the first 4 years of 259 (228-289), 155 (110-200), and 199 (174-224) cells/μL (p<0.01). Discussion: Despite differences in CD4 cell count evolution, death and non-TB AIDS rates were similar across study groups. It is therefore prudent to apply current ART guidelines from resource-rich countries to African populations. © 2012 Pantazis et al.
Authors & Co-Authors
Pantazis, Nikos
Greece, Athens
School of Medicine
Morrison, Charles S.
United States, Durham
Fhi 360
Amornkul, Pauli N.
United States, San Francisco
International Aids Vaccine Initiative
Lewden, Charlotte
France, Bordeaux
Université de Bordeaux
France, Paris
Inserm
Salata, Robert A.
United States, Cleveland
Case Western Reserve University
Minga, Albert Kla
Cote D'ivoire, Abidjan
Programme Pac-ci
Chipato, Tsungai
Zimbabwe, Harare
University of Zimbabwe
Jaffe, Harold W.
United Kingdom, Oxford
University of Oxford
Lakhi, Shabir
Zambia, Lusaka
Zambia Emory Hiv Research Project Zehrp
Karita, Etienne
Rwanda, Kigali
Project San Francisco
Porter, Kholoud
United Kingdom, London
Medical Research Council
Meyer, Laurence J.
France, Paris
Inserm
Touloumi, Giota
Greece, Athens
School of Medicine
Statistics
Citations: 41
Authors: 13
Affiliations: 12
Identifiers
Doi:
10.1371/journal.pone.0032369
e-ISSN:
19326203
Research Areas
Infectious Diseases
Study Design
Cohort Study
Participants Gender
Female