Trends in demographic and clinical characteristics and initiation of antiretroviral therapy among adult patients enrolling in HIV care in the Central Africa International epidemiology Database to Evaluate AIDS (CA‐IeDEA) 2004 to 2018

Jun 27, 2021; Journal of the International AIDS Society. https://doi.org/10.1002/jia2.25672

Abstract

Introduction: The Central Africa International epidemiology Database to Evaluate AIDS (CA-IeDEA) is an open observationalcohort study investigating impact, progression and long-term outcomes of HIV/AIDS among people living with HIV (PLWH) inBurundi, Cameroon, Democratic Republic of Congo (DRC), Republic of Congo (ROC) and Rwanda. We describe trends indemographic, clinical and immunological characteristics as well as antiretroviral therapy (ART) use of patients aged > 15 yearsentering into HIV care in the participating CA-IeDEA site.Methods: Information on sociodemographic characteristics, height, weight, body mass index (BMI), CD4 cell count, WHO stag-ing and ART status at entry into care from 2004 through 2018 were extracted from clinic records of patients aged > 15 yearsenrolling in HIV care at participating clinics in Burundi, Cameroon, DRC, ROC and Rwanda. We assessed trends in patientcharacteristics at enrolment in HIV care including ART initiation within the first 30 days after enrolment in care and calculatedproportions, means and medians (interquartile ranges) for the main variables of interest.Results: Among 69,176 patients in the CA-IeDEA cohort, 39% were from Rwanda, 24% from ROC, 18% from Cameroon,14% from Burundi and 5% from DRC. More women (66%) than men enrolled in care and subsequently initiated ART. Womenwere also younger than men (32 vs. 38 years, P < 0.001) at enrolment and at ART initiation. Trends over time show increasesin median CD4 cell count at enrolment from 190 cells/µL in 2004 to 334 cells/µL in 2018 at enrolment. Among those withcomplete data on CD4 counts (60%), women had a higher median CD4 cell count at care entry than men (229 vs. 249 cells/µL, P < 0.001). Trends in the proportion of patients using ART within 30 days of enrolment at the participating site show anincrease from 16% in 2004 to 75% in 2018.Conclusions: Trends from 2004 to 2018 in the characteristics of patients participating in the CA-IeDEA cohort highlightimprovements at entry into care and subsequent ART initiation including after the implementation of Treat All guidelines inthe participating sites.Keywords: ARV; Africa; cohort studies; HIV epidemiology; low- and middle-income countries; HIV care continuum

Other publication from the same publishing house

Login
Support