The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia
Background: Women are disproportionally affected by HIV and are at greater risk of OIs and malignancies. This study investigated the spectrum of OIs and malignancies among women living with HIV (WLHIV) in Ethiopia. Methods: A retrospective longitudinal study was conducted among 3,817 WLHIV on Antire...
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Taylor & Francis Group
2023-12-01
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| Series: | Emerging Microbes and Infections |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/22221751.2023.2271065 |
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| author | Yimam Getaneh Fentabil Getnet Abdur Rashid Li Kang Qingfei Chu Sisi Li Feng Yi Yiming Shao |
| author_facet | Yimam Getaneh Fentabil Getnet Abdur Rashid Li Kang Qingfei Chu Sisi Li Feng Yi Yiming Shao |
| author_sort | Yimam Getaneh |
| collection | DOAJ |
| description | Background: Women are disproportionally affected by HIV and are at greater risk of OIs and malignancies. This study investigated the spectrum of OIs and malignancies among women living with HIV (WLHIV) in Ethiopia. Methods: A retrospective longitudinal study was conducted among 3,817 WLHIV on Antiretroviral Treatment (ART) from 2007 to 2019 in Ethiopia. Data on OIs, malignancies, and clinical characteristics were retrieved from medical records. Prevalence, incidence, and mortality rates were measured over 13 years of follow-up. The Kaplan-Meier survival curve and multivariable Cox-proportional hazard regression were used to estimate incidence and identify predictors of OIs and malignancies, respectively. Result: The pooled prevalence of OIs or malignancies was 47%. OIs accounted for 39% and malignancies were 23.3%. The incidence of OIs and malignancies were 19.4 (95%CI:9.2-29.5) and 11.5 (95%CI:2.2-20.8) per 100 person-years of observation, respectively. Incidence of candidiasis was 14.1 per 100 person-years followed by Lymphoma (11.9), Cervical Cancer (11.5), and TB (10.9). The risk of OIs was higher in patients with baseline CD4 count ≤500 cells/mm3 [AHR (95%CI): 2.0 (1.8-2.3)] and VL>1000 copies/ml [AHR (95%CI): 1.5 (1.1-1.9)]. Overall, 24.6% died, and of them, 62.2% had a history of OIs or malignancies. The risk of death was higher among WLHIV with a history of Toxoplasmosis, TB and PCP. Conclusion: OIs and malignancies was recently increasing and two-thirds of all deaths were associated with these co-morbidities. The high rates of OIs and malignancies were attributed to poor treatment outcomes. The finding calls to enhance the diagnosis and treatment of these co-morbidities.Abbreviations AIDS: acquired immune deficiency syndrome; CI: confidence interval; EPHI: Ethiopian Public Health Institute; HAART: highly active antiretroviral therapy; HIV: human immunodeficiency virus; HR: hazard ratio; Mg/dl: milligram per deciliter; TB: tuberculosis; PCP: pneumocystis carinii pneumonia; ZJU: Zhejiang University |
| format | Article |
| id | doaj-art-e7ca38dda3f44e2792346feecfe03815 |
| institution | Kabale University |
| issn | 2222-1751 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Emerging Microbes and Infections |
| spelling | doaj-art-e7ca38dda3f44e2792346feecfe038152025-08-20T03:31:10ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512023-12-0112210.1080/22221751.2023.2271065The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in EthiopiaYimam Getaneh0Fentabil Getnet1Abdur Rashid2Li Kang3Qingfei Chu4Sisi Li5Feng Yi6Yiming Shao7State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaEthiopian Public Health Institute, Addis Ababa, EthiopiaSchool of Medicine, Nankai University, Tianjin, People’s Republic of ChinaSchool of Medicine, Nankai University, Tianjin, People’s Republic of ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaState Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaState Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaBackground: Women are disproportionally affected by HIV and are at greater risk of OIs and malignancies. This study investigated the spectrum of OIs and malignancies among women living with HIV (WLHIV) in Ethiopia. Methods: A retrospective longitudinal study was conducted among 3,817 WLHIV on Antiretroviral Treatment (ART) from 2007 to 2019 in Ethiopia. Data on OIs, malignancies, and clinical characteristics were retrieved from medical records. Prevalence, incidence, and mortality rates were measured over 13 years of follow-up. The Kaplan-Meier survival curve and multivariable Cox-proportional hazard regression were used to estimate incidence and identify predictors of OIs and malignancies, respectively. Result: The pooled prevalence of OIs or malignancies was 47%. OIs accounted for 39% and malignancies were 23.3%. The incidence of OIs and malignancies were 19.4 (95%CI:9.2-29.5) and 11.5 (95%CI:2.2-20.8) per 100 person-years of observation, respectively. Incidence of candidiasis was 14.1 per 100 person-years followed by Lymphoma (11.9), Cervical Cancer (11.5), and TB (10.9). The risk of OIs was higher in patients with baseline CD4 count ≤500 cells/mm3 [AHR (95%CI): 2.0 (1.8-2.3)] and VL>1000 copies/ml [AHR (95%CI): 1.5 (1.1-1.9)]. Overall, 24.6% died, and of them, 62.2% had a history of OIs or malignancies. The risk of death was higher among WLHIV with a history of Toxoplasmosis, TB and PCP. Conclusion: OIs and malignancies was recently increasing and two-thirds of all deaths were associated with these co-morbidities. The high rates of OIs and malignancies were attributed to poor treatment outcomes. The finding calls to enhance the diagnosis and treatment of these co-morbidities.Abbreviations AIDS: acquired immune deficiency syndrome; CI: confidence interval; EPHI: Ethiopian Public Health Institute; HAART: highly active antiretroviral therapy; HIV: human immunodeficiency virus; HR: hazard ratio; Mg/dl: milligram per deciliter; TB: tuberculosis; PCP: pneumocystis carinii pneumonia; ZJU: Zhejiang Universityhttps://www.tandfonline.com/doi/10.1080/22221751.2023.2271065Incidencemortalityopportunistic infectionsmalignancyHIV/AIDS |
| spellingShingle | Yimam Getaneh Fentabil Getnet Abdur Rashid Li Kang Qingfei Chu Sisi Li Feng Yi Yiming Shao The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia Emerging Microbes and Infections Incidence mortality opportunistic infections malignancy HIV/AIDS |
| title | The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia |
| title_full | The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia |
| title_fullStr | The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia |
| title_full_unstemmed | The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia |
| title_short | The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia |
| title_sort | spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in ethiopia |
| topic | Incidence mortality opportunistic infections malignancy HIV/AIDS |
| url | https://www.tandfonline.com/doi/10.1080/22221751.2023.2271065 |
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