title: Mortality and morbidity among HIV type-1-infected patients during the first 5 years of a multicountry HIV workplace programme in Africa.
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.
authors.affiliation: Heineken International Health Affairs, Amsterdam, The Netherlands. Stefaan.VanderBorght@heineken.com
authors.forename: Stefaan F
authors.initials: SF
authors.lastname: Van der Borght
authors.forename: Philippe
authors.initials: P
authors.lastname: Clevenbergh
authors.forename: Henk
authors.initials: H
authors.lastname: Rijckborst
authors.forename: Paul
authors.initials: P
authors.lastname: Nsalou
authors.forename: Ngozi
authors.initials: N
authors.lastname: Onyia
authors.forename: Joep M
authors.initials: JM
authors.lastname: Lange
authors.forename: Tobias F Rinke
authors.initials: TF
authors.lastname: de Wit
authors.forename: Maarten F Schim
authors.initials: MF
authors.lastname: Van der Loeff