ART in low-resource settings: how to do more with less

Abstract

In The Lancet today, Margaret May and colleagues 1 May M Boulle A Phiri S et al. for IeDEA Southern Africa and West AfricaPrognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes. Lancet. 2010; (published online July 16.)https://doi.org/10.1016/S0140-6736(10)60666-6 Summary Full Text Full Text PDF Scopus (185) Google Scholar report prognostic models for patients starting antiretroviral therapy in sub-Saharan Africa. The group analysed data from four large scale-up cohorts in the Southern and West African regions that participate in the International epidemiologic Databases to Evaluate AIDS (IeDEA). On the basis of identified risk factors for death, May and colleagues constructed two prognostic models: one with CD4 cell count, clinical stage, bodyweight, age, and sex; and one that replaced CD4 cell count with total lymphocyte count and haemoglobin concentration in the blood. The group concluded that both models provide similarly strong discrimination for prediction of early mortality in patients starting antiretrovirals in sub-Saharan Africa. Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmesPrognostic models should be used to counsel patients, plan health services, and predict outcomes for patients with HIV-1 infection in sub-Saharan Africa. Full-Text PDF