title: Mortality and treatment failure among HIV-infected adults in Dar Es Salaam, Tanzania.
abstract: OBJECTIVE
  Monitoring antiretroviral treatment (ART) outcomes is essential for assessing the success of HIV care and treatment programs in resource-limited settings (RLS).
  
  
  METHODS
  Longitudinal analyses of clinical and immunologic parameters in HIV-infected adults initiated on ART between November 2004 and June 2008 at Management and Development for Health (MDH)-Presidents Emergency Plan For AIDS Relief PEPFAR supported HIV care and treatment clinics in Tanzania.
  
  
  RESULTS
  A total of 12 842 patients were analyzed (65.9% female, median baseline CD4 count, 106 cells/mm(3)). Significant improvements in immunologic status were observed with an increase in CD4 count to 298 (interquartile range [IQR] 199-416), 372 (256-490) and 427 (314-580) cells/mm(3), at 1, 2, and 3 years, respectively. Overall mortality was 13.1% (1682 of 12 842). Male sex, World Health Organization (WHO) stage III/IV, CD4 <200 cells/mm(3), hemoglobin (Hgb) <8.5 g/dL, and stavudine (d4T)-containing regimens were independently associated with early and overall mortality.
  
  
  CONCLUSIONS
  Closer monitoring of males and patients with advanced HIV disease following ART initiation may improve clinical and immunologic outcomes in these individuals.
authors.affiliation: 1Harvard School of Public Health, Boston, MA, USA.
authors.forename: Guerino
authors.initials: G
authors.lastname: Chalamilla
authors.forename: Claudia
authors.initials: C
authors.lastname: Hawkins
authors.forename: James
authors.initials: J
authors.lastname: Okuma
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Akum
authors.initials: A
authors.lastname: Aveika
authors.forename: Beatrice
authors.initials: B
authors.lastname: Christian
authors.forename: Happiness
authors.initials: H
authors.lastname: Koda
authors.forename: Sylvia
authors.initials: S
authors.lastname: Kaaya
authors.forename: Deo
authors.initials: D
authors.lastname: Mtasiwa
authors.forename: Wafaie
authors.initials: W
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003906:Developing Countries; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D018119:Stavudine / Q000627:therapeutic use; D013636:Tanzania / Q000453:epidemiology; D017211:Treatment Failure
chemical_list: D019380:Anti-HIV Agents; D006454:Hemoglobins; D018119:Stavudine