title: Incidence of AIDS-Defining Opportunistic Infections and Mortality during Antiretroviral Therapy in a Cohort of Adult HIV-Infected Individuals in Hanoi, 2007-2014.
abstract: BACKGROUND
  Although the prognosis for HIV-infected individuals has improved after antiretroviral therapy (ART) scale-up, limited data exist on the incidence of AIDS-defining opportunistic infections (ADIs) and mortality during ART in resource-limited settings.
  
  
  METHODS
  HIV-infected adults in two large hospitals in urban Hanoi were enrolled to the prospective cohort, from October 2007 through December 2013. Those who started ART less than one year before enrollment were assigned to the survival analysis. Data on ART history and ADIs were collected retrospectively at enrollment and followed-up prospectively until April 2014.
  
  
  RESULTS
  Of 2,070 cohort participants, 1,197 were eligible for analysis and provided 3,446 person-years (PYs) of being on ART. Overall, 161 ADIs episodes were noted at a median of 3.20 months after ART initiation (range 0.03-75.8) with an incidence 46.7/1,000 PYs (95% confidence interval [CI] 39.8-54.5). The most common ADI was tuberculosis with an incidence of 29.9/1,000 PYs. Mortality after ART initiation was 8.68/1,000 PYs and 45% (19/45) died of AIDS-related illnesses. Age over 50 years at ART initiation was significantly associated with shorter survival after controlling for baseline CD4 count, but neither having injection drug use (IDU) history nor previous ADIs were associated with poor survival. Semi-competing risks analysis in 951 patients without ADIs history prior to ART showed those who developed ADIs after starting ART were at higher risk of death in the first six months than after six months.
  
  
  CONCLUSIONS
  ADIs were not rare in spite of being on effective ART. Age over 50 years, but not IDU history, was associated with shorter survival in the cohort. This study provides in-depth data on the prognosis of patients on ART in Vietnam during the first decade of ART scale-up.
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.|Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Junko
authors.initials: J
authors.lastname: Tanuma
authors.affiliation: Epidemiology and Biostatistics Core, The Forsyth Institute, Cambridge, Massachusetts, United States of America.
authors.forename: Kyu Ha
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Haneuse
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: HIV Department, National Hospital of Tropical Disease, Hanoi, Vietnam.
authors.forename: Dung Thi
authors.initials: DT
authors.lastname: Nguyen
authors.affiliation: HIV Department, National Hospital of Tropical Disease, Hanoi, Vietnam.
authors.forename: Dung Thi Hoai
authors.initials: DT
authors.lastname: Nguyen
authors.affiliation: Infectious Disease Department, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Cuong Duy
authors.initials: CD
authors.lastname: Do
authors.affiliation: Infectious Disease Department, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Thuy Thanh
authors.initials: TT
authors.lastname: Pham
authors.affiliation: HIV Department, National Hospital of Tropical Disease, Hanoi, Vietnam.
authors.forename: Kinh Van
authors.initials: KV
authors.lastname: Nguyen
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002423:Cause of Death; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012189:Retrospective Studies; D014744:Vietnam / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents