Table 1.
Characteristics at Admission | Total (N = 146) | VL Relapse (N = 44) | No VL Relapse (N = 102) | P |
---|---|---|---|---|
Sex, n (%) | ||||
Male | 140 (95.9) | 43 (97.7) | 97 (95.1) | .67a |
Female | 6 (4.1) | 1 (2.3) | 5 (4.9) | |
Residential status, n (%); n = 142 | ||||
Migrant worker | 70 (49.3) | 25 (59.5) | 45 (45.0) | .24a |
Resident | 70 (49.3) | 17 (40.5) | 53 (53.0) | |
Settler | 2 (1.4) | 0 (0.0) | 2 (2.0) | |
Age (years), median (IQR) | 31 (27–38) | 30.5 (27−39) | 31.5 (27–37) | .61b |
VL history, n (%) | ||||
Primary VL | 110 (75.3) | 35 (79.6) | 75 (73.5) | .44c |
Relapse VL | 36 (24.7) | 9 (20.4) | 27 (26.5) | |
Spleen size (cm), median (IQR); n = 144 | 5 (3−8) | 5 (3−7) | 5 (3−8) | .72b |
Body mass index (kg/m 2 ), median (IQR); n = 134 | 16 (15−18) | 16 (15−17) | 16 (15−18) | .96b |
Hemoglobin (g/dL), median (IQR); n = 144 | 8.7 (7.2–10.1) | 9.2 (7.5−10.2) | 8.5 (6.9−9.8) | .14b |
Parasitological test result at VL diagnosis, n (%)d | ||||
<6+ | 84 (57.5) | 26 (59.1) | 58 (56.9) | .11c |
6+ | 22 (15.1) | 10 (22.7) | 12 (11.7) | |
Not done: serological/clinical diagnosis | 40 (27.4) | 8 (18.2) | 32 (31.4) | |
Tuberculosis, n (%); n = 145 | ||||
Yes | 32 (22.1) | 10 (23.3) | 22 (21.6) | .82c |
No | 113 (77.9) | 33 (76.7) | 80 (78.4) | |
WHO stage, n (%); n = 111 | ||||
III | 5 (4.5) | 1 (2.9) | 4 (5.3) | 1.00a |
IV | 106 (95.5) | 34 (97.1) | 72 (94.7) | |
CD4 count (cells/µL)e, median (IQR); n = 84 | 149 (65−256) | 139 (56−209) | 180 (74−278) | .19b |
CD4 count (cells/µL), n (%)e; n = 84 | ||||
≤100 | 32 (38.1) | 11 (42.3) | 21 (36.2) | .75a |
101−199 | 21 (25.0) | 7 (26.9) | 14 (24.2) | |
200−349 | 19 (22.6) | 6 (23.1) | 13 (22.4) | |
≥350 | 12 (14.3) | 2 (7.7) | 10 (17.2) | |
Advanced HIV infection, n (%)f; n = 133 | ||||
Yes | 110 (82.7) | 36 (83.7) | 74 (82.2) | .83c |
No | 23 (17.3) | 7 (16.3) | 16 (17.8) | |
ART regimen, n (%)g | ||||
Tenofovir-based regimen | 64 (43.8) | 15 (34.1) | 49 (48.0) | .01a |
Non–tenofovir-based regimen | 76 (52.1) | 24 (54.5) | 52 (51.0) | |
None | 6 (4.1) | 5 (11.4) | 1 (1.0) | |
Timing of ART initiation, n (%); n = 144 | ||||
ART initiated before VL episode | 57 (39.6) | 13 (29.6) | 44 (44.0) | .002a |
Duration on ART (months) at VL diagnosis, median (IQR) | 6.8 (1.9−15.9) | 9.4 (4.1−29.6) | 5.7 (1.3−15.2) | |
ART initiated during VL treatment | 40 (27.8) | 8 (18.2) | 32 (32.0) | |
ART initiated after VL treatment | 41 (28.5) | 18 (40.9) | 23 (23.0) | |
ART never initiated | 6 (4.2) | 5 (11.4) | 1 (1.0) | |
Initial VL treatment regimen, n (%) | ||||
AmBisome and Miltefosine | 59 (40.4) | 13 (29.6) | 46 (45.1) | .08c |
Other (AmBisome or sodium stibogluconate) | 87 (59.6) | 31 (70.4) | 56 (54.9) | |
Outcome of first VL episode treated, n (%); n = 139 | ||||
Clinical cure | 82 (59.0) | 25 (59.5) | 57 (58.8) | .93c |
Parasitological cure | 57 (41.0) | 17 (40.5) | 40 (41.2) | |
Characteristics at discharge | ||||
Spleen size (cm), median (IQR); n = 139 | 0 (0−3) | 0 (0−2) | 0 (0−3) | .21b |
Body mass index (kg/m 2 ), median (IQR); n = 145 | 17 (16−18) | 17 (16−19) | 17 (16−18) | .37b |
Hemoglobin (g/dL), median (IQR); n = 137 | 9.1 (8.2−10.5) | 8.9 (8.2−10.3) | 9.1 (8.2−10.5) | .96b |
Duration of follow-up (months), median (IQR) | 11.4 (4.0−30.0) | 7.8 (3.9−15.3) | 14.4 (4.5−38.7) | .009b |
Abbreviations: ART, antiretroviral therapy; HIV, human immunodeficiency virus; IQR, interquartile range; VL, visceral leishmaniasis;WHO, World Health Organization.
aFisher exact test.
b2-sample Wilcoxon rank-sum (Mann-Whitney) test.
cχ2 test.
d97 (66.4%) spleen aspirates, 1 bone marrow aspirate (0.7%), 8 lymph node aspirates (5.5%), and 40 (27.4%)—37 primary VL cases and 3 relapse cases—had no parasitological test done.
eCD4 count result is <6 months from VL treatment initiation.
fWHO stage IV or CD4 <50 cells/µL.
gStavudine, lamivudine, and nevirapine; zidovudine, lamivudine, and efavirenz; tenofovir, lamivudine, and efavirenz; zidovudine, lamivudine, and nevirapine; stavudine, lamivudine, and efavirenz.