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HIV in Resource Limited Settings: Clinical Manifestations and Testing Strategies
Wednesday, 1:30 - 3:30 pm
Background: HIV-negative Ethiopians have lower CD4+
T-cell (CD4) counts compared with any other population in
We used data from an
open cohort among factory workers in
Results: The 149 Ethiopians contributed 791 visits. Their mean age at intake was 34 years and 69% were males. At the first HIV-positive visit, the median CD4 count was 327 x 106/mL. During active follow-up 29 individuals died, giving an incidence of death of 6.7 per 100 person-years. We estimated median survival time from HIV seroconversion to death in the range of 9.1 to 13.0 years using three different approaches. Regardless baseline CD4 cell counts, the annual cell loss was lower for Ethiopians compared to Dutch individuals (p <0.01) (see the figure). For example, at 327 CD4 cell counts, the annual loss for Ethiopians was 32 cells, while this was 68 and 79 cells for Dutch drug users and homosexual men, respectively. Although Dutch individuals who lack SI strains have a lower rate of CD4 decline than Dutch who have such strains, they still have a faster CD4 decline than Ethiopians (p <0.05).
Conclusions: Survival time in HIV-infected Ethiopians is similar to that of populations in industrialized countries before the advent of antiretroviral therapy. The generally low baseline CD4 counts among Ethiopians do not imply shorter HIV survival time than in other populations.
Keywords: HIV disease progression; CD4; Ethiopia