TY - JOUR

T1 - Life expectancy of HIV-infected patients followed at the largest hospital in Guinea-Bissau is one-fourth of life expectancy of the background population

AU - Engell-Sørensen, Thomas

AU - Rieckmann, Andreas

AU - Medina, Candida

AU - da Silva Té, David

AU - Rodrigues, Amabelia

AU - Fisker, Ane Bærent

AU - Aaby, Peter

AU - Erikstrup, Christian

AU - Jespersen, Sanne

AU - Wejse, Christian

AU - Hønge, Bo Langhoff

AU - da Silva, Zacarias

AU - Oliviera-Souto, Ines

AU - Østergaard, Lars

AU - Laursen, Alex

AU - Fomsgaard, Anders

AU - for the Bissau HIV Cohort study group

PY - 2021

Y1 - 2021

N2 - Purpose: To estimate the life expectancy (LE) of HIV-infected patients in the West African country Guinea-Bissau and compare it with the background population. Methods: Using data from the largest HIV outpatient clinic at the Hospital Nacional Simão Mendes in the capital Bissau, a retrospective observational cohort study was performed. The study included patients attending the clinic between June 2005 and January 2018. A total of 8958 HIV-infected patients were included. In the analysis of the background population, a total of 109,191 people were included. LE incorporating loss to follow-up (LTFU) was estimated via Kaplan–Meier estimators using observational data on adult HIV-infected patients and background population. Results: The LE of 20-year-old HIV-infected patients was 9.8 years (95% CI 8.3–11.5), corresponding to 22.3% (95% CI 18.5–26.7%) of the LE of the background population. (LE for 20-year-olds in the background population was 44.0 years [95% CI 43.0–44.9].) Patients diagnosed with CD4 cell counts below 200 cells/µL had a LE of 5.7 years (95% CI 3.6–8.2). No increase in LE with later calendar period of diagnosis was observed. Conclusions: LE was shown to be markedly lower among HIV-infected patients compared with the background population. While other settings have shown marked improvements in prognosis of HIV-infected patients in recent years, no improvement in Bissau was observed over time (9.8 years (95% CI 7.6–12.2) and 9.9 years (95% CI 7.6–12.1) for the periods 2005–2010 and 2014–2016, respectively).

AB - Purpose: To estimate the life expectancy (LE) of HIV-infected patients in the West African country Guinea-Bissau and compare it with the background population. Methods: Using data from the largest HIV outpatient clinic at the Hospital Nacional Simão Mendes in the capital Bissau, a retrospective observational cohort study was performed. The study included patients attending the clinic between June 2005 and January 2018. A total of 8958 HIV-infected patients were included. In the analysis of the background population, a total of 109,191 people were included. LE incorporating loss to follow-up (LTFU) was estimated via Kaplan–Meier estimators using observational data on adult HIV-infected patients and background population. Results: The LE of 20-year-old HIV-infected patients was 9.8 years (95% CI 8.3–11.5), corresponding to 22.3% (95% CI 18.5–26.7%) of the LE of the background population. (LE for 20-year-olds in the background population was 44.0 years [95% CI 43.0–44.9].) Patients diagnosed with CD4 cell counts below 200 cells/µL had a LE of 5.7 years (95% CI 3.6–8.2). No increase in LE with later calendar period of diagnosis was observed. Conclusions: LE was shown to be markedly lower among HIV-infected patients compared with the background population. While other settings have shown marked improvements in prognosis of HIV-infected patients in recent years, no improvement in Bissau was observed over time (9.8 years (95% CI 7.6–12.2) and 9.9 years (95% CI 7.6–12.1) for the periods 2005–2010 and 2014–2016, respectively).

KW - Guinea-Bissau

KW - HIV

KW - HIV-2

KW - Life expectancy

KW - Loss to follow-up

KW - Mortality

U2 - 10.1007/s15010-020-01574-6

DO - 10.1007/s15010-020-01574-6

M3 - Journal article

C2 - 33528814

AN - SCOPUS:85100438954

VL - 49

SP - 631

EP - 643

JO - Therapies

JF - Therapies

SN - 0300-8126

ER -