title: Mortality and immunovirological outcomes on antiretroviral therapy in HIV-1 and HIV-2-infected individuals in the Gambia.
abstract: OBJECTIVE
  This study's objective was to assess outcomes in HIV-1 and HIV-2 infected antiretroviral therapy (ART)-naïve patients starting ART in the Gambia, West Africa.
  
  
  METHODS
  A cohort design was used to estimate survival in ART patients and determine whether survival and time to virologic failure varied across patient subgroups.
  
  
  METHODS
  Mortality, virologic failures and CD4(+) cell recovery were assessed in a clinical cohort of patients from the Genito-Urinary Medicine (GUM) clinic of the MRC Laboratories in the Gambia. Kaplan-Meier estimates of survival were determined for mortality and virologic failure. A Cox proportional hazards model was used to identify baseline demographic, clinical, immunologic and virologic factors associated with increased risk of death.
  
  
  RESULTS
  The overall Kaplan-Meier estimate of survival to 36 months was 73.4% (66.5, 80.3). Survival was marginally higher in HIV-2-infected patients compared to HIV-1-infected patients; it was significantly higher in patients with a baseline CD4(+) lymphocyte cell count of greater than 50 cells/μl compared to those with a baseline CD4(+) count of less than 50 cells/μl. CD4(+) cell recovery was faster in HIV-1-infected individuals compared to HIV-2-infected patients up to 24 months, although this did not result higher mortality in the latter group. No differences in virologic failure were observed by HIV type.
  
  
  CONCLUSIONS
  HIV-1 and HIV-2-infected patients receiving ART in a clinical setting in the Gambia had good survival to 36 months. HIV-2-infected patients did as well as HIV-1-infected patients in terms of long-term immunological and virological responses and overall survival.
authors: ICAP, Columbia University, Mbabane, Swaziland. idpet2@gmail.com
authors: Ingrid
authors: I
authors: Peterson
authors: Oluwatoyin
authors: O
authors: Togun
authors: Thushan
authors: T
authors: de Silva
authors: Francis
authors: F
authors: Oko
authors: Sarah
authors: S
authors: Rowland-Jones
authors: Assan
authors: A
authors: Jaye
authors: Kevin
authors: K
authors: Peterson
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000401:mortality; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005714:Gambia / Q000453:epidemiology; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality*; D015497:HIV-1 / Q000276:immunology; D015498:HIV-2 / Q000276:immunology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017211:Treatment Failure; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents