title: HIV-1-related morbidity in adults, Abidjan, Côte d'Ivoire: a nidus for bacterial diseases.
abstract: We studied mortality and morbidity in 270 HIV-1-infected adults (60% women, median age 31 years, mean baseline CD4 count 331/mm(3) ) observed in a follow-up that lasted a median 10 months in Côte d'Ivoire. Survival and probability of remaining free from any episode of morbidity at 12 months were 0.80 and 0.50, respectively. Baseline CD4 count <200/mm(3) was the only variable associated with global morbidity and mortality, with hazard ratios of 2.50 and 7.57, respectively. The most frequent causes of morbidity were severe bacterial infections (incidence rate: 26.1 per 100 person-years [py]), followed by oral candidiasis (22.3% py), unexplained weight loss over 10% of baseline body weight (13.3% py), tuberculosis (10.1% py), unexplained chronic diarrhea (9.7% py), and isosporiasis (5.1% py). Nontyphoid Salmonella accounted for 37% of isolated strains during severe bacterial infections, followed by Streptococcus pneumoniae (34%), Escherichia coli (15%), and Shigella species (7%). A significant part of bacterial morbidity occurred in patients with baseline CD4 count > or = 200/mm(3), in whom the incidence rate of bacterial diseases was 21.3% py and the probability of remaining free from any bacterial infection at 12 months was 0.80 (vs. 36.4% py and 0.71 in patients with baseline CD4 count <200/mm(3); p =.07).
authors.affiliation: Service de Gastro-Entérologie, CHU de Yopougon, Abidjan; Program PAC-CI, Abidjan, Côte d'Ivoire.
authors.forename: A
authors.initials: A
authors.lastname: Attia
authors.forename: C
authors.initials: C
authors.lastname: Huët
authors.forename: X
authors.initials: X
authors.lastname: Anglaret
authors.forename: S
authors.initials: S
authors.lastname: Toure
authors.forename: T
authors.initials: T
authors.lastname: Ouassa
authors.forename: G
authors.initials: G
authors.lastname: Gourvellec
authors.forename: H
authors.initials: H
authors.lastname: Menan
authors.forename: N
authors.initials: N
authors.lastname: Dakoury-Dogbo
authors.forename: P
authors.initials: P
authors.lastname: Combe
authors.forename: G
authors.initials: G
authors.lastname: Chêne
authors.forename: T
authors.initials: T
authors.lastname: N'Dri-Yoman
authors.forename: R
authors.initials: R
authors.lastname: Salamon
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology* / Q000209:etiology; D007560:Cote d'Ivoire / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies