Xavier Argemi|Som Dara|Seng Chan You|Jean F. Mattei|C Courpotin|Bernard Simon|Yves Hansmann|D. Christmann|Nicolas Lefèbvre
Impact of malnutrition and social determinants on survival of HIV-infected adults starting antiretroviral therapy in resource-limited settings
Hôpital Civil, Strasbourg|Sihanouk Hospital Center of HOPE|Sihanouk Hospital Center of HOPE|Hôpital Civil, Strasbourg|Hôpital Civil, Strasbourg|Hôpital Civil, Strasbourg
objectives determining impact malnutrition anaemia social determinants survival starting antiretroviral therapy art cohort hivinfected adults rural hiv care centre sihanoukville cambodia methods retrospective descriptive cohort study adults starting art december 2004 july 2009 used kaplanmeier cox regression survival analyses identify predictors death results 1002 patients 497 men median age 40 median time followup 24 years 104 died followup baseline median cd4 cell count 83 cellsl 799 stage iii iv multivariate analysis malnutrition appeared strong independent risk factor death 112 bmi less 16 kgm2 hazard ratio 697 95 confidence interval ci 3511389 215 bmi 16 18 kgm2 hazard ratio 288 95 ci 142582 308 bmi 18 20 kgm2 hazard ratio 218 95 ci 109436 severe anaemia haemoglobin 84 gdl cd4 cell count 100 cellsl also predicted mortality hazard ratio 225 95 ci 102434 229 95 ci 101297 respectively social determinants significantly associated death univariate analysis conclusion malnutrition anaemia strong independent prognostic factors time starting art nutritional cares essential clinical success hiv programs started developing countries