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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Association of serum albumin concentration with mortality, morbidity, CD4 T-cell reconstitution among tanzanians initiating antiretroviral therapy
Journal of Infectious Diseases, Volume 207, No. 9, Year 2013
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Description
Background. Prospective studies of serum albumin concentration measurement as a low-cost predictor of human immunodeficiency virus (HIV) disease progression are needed for individuals initiating antiretroviral therapy (ART) in resource-limited settings.Methods. Serum albumin concentration was measured at ART initiation for 2145 adults in Tanzania who were enrolled in a trial examining the effect of multivitamins on HIV disease progression. Participants were prospectively followed for mortality, morbidity, and anthropometric outcomes at monthly visits (median follow-up duration, 21.2 months). Proportional hazard models were used to analyze mortality, morbidity, and nutritional outcomes, while generalized estimating equations were used to analyze CD4+ T-cell counts.Results. Individuals with hypoalbuminemia (defined as a serum albumin concentration of <35 g/L) at ART initiation had a hazard of death that was 4.52 times (95% confidence interval, 3.37-6.07; P <. 001) that of individuals with serum albumin concentrations of ≥35 g/L, after multivariate adjustment. Hypoalbuminemia was also independently associated with the incidence of pulmonary tuberculosis (P <. 001), severe anemia (P <. 001), wasting (P =. 002), and >10% weight loss (P =. 012). Secondary analyses suggested that serum albumin concentrations of <38 g/L were associated with increased mortality and incident pulmonary tuberculosis. There was no association between serum albumin concentration and changes in CD4 + T-cell counts (P =. 121).Conclusions. Serum albumin concentrations can identify adults initiating ART who are at high risk for mortality and selected morbidities. Future research is needed to identify and manage conditions that reduce the serum albumin concentration. © 2013 The Author.
Authors & Co-Authors
Sudfeld, Christopher Robert
Unknown Affiliation
Isanaka, Sheila
United States, Boston
Harvard T.h. Chan School of Public Health
Aboud, Said
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Mugusi, Ferdinand M.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Wang, Molin
United States, Boston
Harvard T.h. Chan School of Public Health
Chalamilla, Guerino E.
United States, Boston
Harvard T.h. Chan School of Public Health
Tanzania, Dar es Salaam
Management and Development for Health
Fawzi, Wafaie W.
United States, Boston
Harvard T.h. Chan School of Public Health
Statistics
Citations: 42
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.1093/infdis/jit027
ISSN:
00221899
Research Areas
Environmental
Infectious Diseases
Study Design
Cohort Study
Study Locations
Tanzania