2010. 9 p.
Authors: 
May, Margaret
Bulle, Andrew
Phiri, Sam
Messou, Eugene
Myer, Landon
Wood, Robin
Keiser, Olivia
Sterne, Jonathan A. C.
Dabis, François
Egger, Matthias
Periodical title: 
The Lancet, 376, 9739
Description: 
Prognostic models have been developed for patients infected with HIV-1 who start combination antiretroviral therapy (ART) in high-income countries, but not for patients in sub-Saharan Africa. The article shows the development of two prognostic models to estimate the probability of death in patients starting ART in sub-Saharan Africa. Data for adult patients who started ART in four scale-up programmes in Côte d'Ivoire, South Africa, and Malawi from 2004 to 2007 are analised. Patients lost to follow-up in the first year were excluded. Weibull survival models to construct two prognostic models were used: one with CD4 cell count, clinical stage, bodyweight, age, and sex (CD4 count model); and one that replaced CD4 cell count with total lymphocyte count and severity of anaemia (total lymphocyte and haemoglobin model), because CD4 cell count is not routinely measured in many African ART programmes. Death from all causes in the first year of ART was the primary outcome. Based on the results achieved, the article states that prognostic models should be used to counsel patients, plan health services, and predict outcomes for patients with HIV-1 infection in sub-Saharan Africa.
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