title: High early mortality in patients with chronic acquired immunodeficiency syndrome diarrhea initiating antiretroviral therapy in Haiti: a case-control study.
abstract: This case-control study examines whether chronic diarrhea at initiation of antiretroviral therapy (ART) affects survival of human immunodefiency virus-infected patients. Cases (288) were treatment-naive, non-pregnant, adults with self report of frequent loose stool for > 3 weeks at the time ART was initiated. One-third of patients had an enteric pathogen identified including Cryptosporidium spp., Giardia spp., Isospora belli, Cyclospora cayetanensis, and Entamoeba histolytica. Control patients (400) did not have diarrhea when initiating ART. At six weeks, mortality was 10% in the patients with diarrhea and 5% in the patients without diarrhea (P = 0.009). Chronic diarrhea in patients requesting ART in Haiti is associated with increased early mortality.
authors.affiliation: University of Virginia, Charlottesville, Virginia 22903, USA. rd8v@virginia.edu
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Dillingham
authors.forename: Relana
authors.initials: R
authors.lastname: Pinkerton
authors.forename: Paul
authors.initials: P
authors.lastname: Leger
authors.forename: Patrice
authors.initials: P
authors.lastname: Severe
authors.forename: Richard L
authors.initials: RL
authors.lastname: Guerrant
authors.forename: J William
authors.initials: JW
authors.lastname: Pape
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003967:Diarrhea / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D010272:Parasitic Diseases / Q000150:complications / Q000401:mortality; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D015662:Trimethoprim, Sulfamethoxazole Drug Combination