IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0223411.html
   My bibliography  Save this article

Predictors of mortality within the first year of initiating antiretroviral therapy in urban and rural Kenya: A prospective cohort study

Author

Listed:
  • Rachel A Silverman
  • Grace C John-Stewart
  • Ingrid A Beck
  • Ross Milne
  • Catherine Kiptinness
  • Christine J McGrath
  • Barbra A Richardson
  • Bhavna Chohan
  • Samah R Sakr
  • Lisa M Frenkel
  • Michael H Chung

Abstract

Introduction: Despite increased treatment availability, HIV-infected individuals continue to start antiretroviral therapy (ART) late in disease progression, increasing early mortality risk. Materials and methods: Nested prospective cohort study within a randomized clinical trial of adult patients initiating ART at clinics in urban Nairobi and rural Maseno, Kenya, between 2013–2014. We estimated mortality incidence rates following ART initiation and used Cox proportional hazards regression to identify predictors of mortality within 12 months of ART initiation. Analyses were stratified by clinic site to examine differences in mortality correlates and risk by location. Results: Among 811 participants initiated on ART, the mortality incidence rate within a year of initiating ART was 7.44 per 100 person-years (95% CI 5.71, 9.69). Among 207 Maseno and 612 Nairobi participants initiated on ART, the mortality incidence rates (per 100 person-years) were 12.78 (95% CI 8.49, 19.23) and 5.72 (95% CI 4.05, 8.09). Maseno had a 2.20-fold greater risk of mortality than Nairobi (95% CI 1.29, 3.76; P = 0.004). This association remained [adjusted hazard ratio (HR) = 2.09 (95% CI 1.17, 3.74); P = 0.013] when adjusting for age, gender, education, pre-treatment drug resistance (PDR), and CD4 count, but not when adjusting for BMI. In unadjusted analyses, other predictors (P

Suggested Citation

  • Rachel A Silverman & Grace C John-Stewart & Ingrid A Beck & Ross Milne & Catherine Kiptinness & Christine J McGrath & Barbra A Richardson & Bhavna Chohan & Samah R Sakr & Lisa M Frenkel & Michael H Ch, 2019. "Predictors of mortality within the first year of initiating antiretroviral therapy in urban and rural Kenya: A prospective cohort study," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-19, October.
    • Handle: RePEc:plo:pone00:0223411
    DOI: 10.1371/journal.pone.0223411
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223411
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0223411&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0223411?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Andrew G Flynn & Godwin Anguzu & Frank Mubiru & Agnes N Kiragga & Moses Kamya & David B Meya & David R Boulware & Andrew Kambugu & Barbara C Castelnuovo, 2017. "Socioeconomic position and ten-year survival and virologic outcomes in a Ugandan HIV cohort receiving antiretroviral therapy," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-12, December.
    2. Monisha Sharma & Roger Ying & Gillian Tarr & Ruanne Barnabas, 2015. "Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa," Nature, Nature, vol. 528(7580), pages 77-85, December.
    3. Amita Gupta & Girish Nadkarni & Wei-Teng Yang & Aditya Chandrasekhar & Nikhil Gupte & Gregory P Bisson & Mina Hosseinipour & Naveen Gummadi, 2011. "Early Mortality in Adults Initiating Antiretroviral Therapy (ART) in Low- and Middle-Income Countries (LMIC): A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 6(12), pages 1-11, December.
    4. Kara G Marson & Kenneth Tapia & Pamela Kohler & Christine J McGrath & Grace C John-Stewart & Barbra A Richardson & Julia W Njoroge & James N Kiarie & Samah R Sakr & Michael H Chung, 2013. "Male, Mobile, and Moneyed: Loss to Follow-Up vs. Transfer of Care in an Urban African Antiretroviral Treatment Clinic," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Arielle Lasry & Mireille B Kalou & Paul R Young & Jacqueline Rurangirwa & Bharat Parekh & Stephanie Behel, 2019. "Cost implications of HIV retesting for verification in Africa," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-15, July.
    2. Annisa Rahmalia & Michael Holton Price & Yovita Hartantri & Bachti Alisjahbana & Rudi Wisaksana & Reinout van Crevel & Andre J A M van der Ven, 2019. "Are there differences in HIV retention in care between female and male patients in Indonesia? A multi-state analysis of a retrospective cohort study," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-17, June.
    3. Dominic Bukenya & Janet Seeley & Grace Tumwekwase & Elizabeth Kabunga & Eugene Ruzagira, 2020. "How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda," SAGE Open, , vol. 10(1), pages 21582440199, January.
    4. Victor Riitho & Roisin Connon & Agnes Gwela & Josephine Namusanje & Ruth Nhema & Abraham Siika & Mutsa Bwakura-Dangarembizi & Victor Musiime & James A. Berkley & Alex J. Szubert & Diana M. Gibb & A. S, 2024. "Biomarkers of mortality in adults and adolescents with advanced HIV in sub-Saharan Africa," Nature Communications, Nature, vol. 15(1), pages 1-11, December.
    5. Marc d'Elbée & Métogara Mohamed Traore & Kéba Badiane & Anthony Vautier & Arlette Simo Fotso & Odé Kanku Kabemba & Nicolas Rouveau & Peter Godfrey-Faussett & Mathieu Maheu-Giroux & Marie-Claude Boily , 2021. "Costs and Scale-Up Costs of Integrating HIV Self-Testing Into Civil Society Organisation-Led Programmes for Key Populations in Côte d'Ivoire, Senegal, and Mali," Post-Print ird-03883601, HAL.
    6. Lawrence Mwenge & Linda Sande & Collin Mangenah & Nurilign Ahmed & Sarah Kanema & Marc d’Elbée & Euphemia Sibanda & Thokozani Kalua & Gertrude Ncube & Cheryl C Johnson & Karin Hatzold & Frances M Cowa, 2017. "Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-16, October.
    7. Sailly Dave & Trevor Peter & Clare Fogarty & Nicolaos Karatzas & Nandi Belinsky & Nitika Pant Pai, 2019. "Which community-based HIV initiatives are effective in achieving UNAIDS 90-90-90 targets? A systematic review and meta-analysis of evidence (2007-2018)," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-18, July.
    8. Paul Wekesa & Jaquin Kataka & Kevin Owuor & Lennah Nyabiage & Fredrick Miruka & Stella Wanjohi & Samuel Omondi, 2020. "Time to HIV testing of sexual contacts identified by HIV-positive index clients in Siaya County, Kenya," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-11, September.
    9. Winnie Kavulani Luseno & Samuel H. Field & Bonita J. Iritani & Fredrick S. Odongo & Daniel Kwaro & Stuart Rennie, 2022. "Does Venue of HIV Testing and Results Disclosure in the Context of a Research Study Affect Adolescent Health and Behavior? Results from a Study in Western Kenya," IJERPH, MDPI, vol. 19(6), pages 1-15, March.
    10. Pamela Bachanas & Mary Grace Alwano & Refeletswe Lebelonyane & Lisa Block & Stephanie Behel & Elliot Raizes & Gene Ussery & Huisheng Wang & Faith Ussery & Molly Pretorius Holme & Connie Sexton & Sherr, 2021. "Finding, treating and retaining persons with HIV in a high HIV prevalence and high treatment coverage country: Results from the Botswana Combination Prevention Project," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-14, April.
    11. Joseph Kamanga & Kayla Stankevitz & Andres Martinez & Robert Chiegil & Lameck Nyirenda & Florence Mulenga & Mario Chen & Mulamuli Mpofu & Sam Lubasi & Moses Bateganya, 2021. "Improved HIV case finding among key populations after differentiated data driven community testing approaches in Zambia," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-13, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0223411. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.