Table 1.
Baseline characteristics, twelve‐month and ten‐year outcomes of patients on ART for ten years at an HIV clinic in Johannesburg, South Africa (n = 6644)
| Year 1 (n = 1824)a | Year 2 (n = 2189)a | Year 3 (n = 2631)a | Total (N = 6644) | |
|---|---|---|---|---|
| N (%) | N (%) | N (%) | N (%) | |
| Total N | 1824 (27.5) | 2189 (32.9) | 2631 (39.6) | 6644 |
| Patient baseline characteristics | ||||
| Sex | ||||
| Male | 562 (30.8) | 718 (32.8) | 950 (36.1) | 2230 (33.6) |
| Female | 1262 (69.2) | 1471 (67.2) | 1681 (63.9) | 4414 (66.4) |
| Age at HAART initiation (years) | ||||
| Median (IQR) | 35.3 (30.4 to 41.7) | 34.5 (30.1 to 40.4) | 35.6 (30.7 to 42.1) | 35.2 (30.4 to 41.1) |
| Males | 37.9 (32.8 to 43.8) | 36.8 (32.7 to 42.7) | 37.5 (32.8 to 43.4) | 37.2 (32.8 to 43.3) |
| Females | 34.3 (29.6 to 40.5) | 33.1 (29.1 to 39.1) | 34.4 (29.2 to 40.9) | 34.0 (29.3 to 40.1) |
| 18 to 24.9 | 84 (4.6) | 154 (7.0) | 153 (5.8) | 391 (5.9) |
| 25 to 29.9 | 321 (17.6) | 378 (17.3) | 421 (16.0) | 1120 (16.9) |
| 30 to 39.9 | 865 (47.4) | 1082 (49.4) | 1217 (46.3) | 3164 (47.6) |
| 40 to 49.9 | 402 (22.0) | 427 (19.5) | 635 (24.1) | 1464 (22.0) |
| >50 | 152 (8.3) | 148 (6.8) | 205 (7.8) | 505 (7.6) |
| Nationality | ||||
| Non‐South African | 44 (2.4) | 98 (4.5) | 137 (5.2) | 279 (4.2) |
| South African | 1780 (97.6) | 2090 (95.5) | 2493 (94.8) | 6363 (95.8) |
| Males | 545 (97.0) | 685 (95.4) | 883 (93.0) | 2113 (94.8) |
| Females | 1235 (97.9) | 1405 (95.5) | 1610 (95.8 | 4250 (96.3) |
| Missing | 0 (0.0) | 1 (0.0) | 1 (0.0) | 2 (0.0) |
| CD4 count category (cells/mm3) | ||||
| Median (IQR) | 89 (39 to 152) | 92 (32 to 163) | 89 (29 to 164) | 90 (33 to 161) |
| Males | 83 (35 to 142) | 62 (19 to 140) | 74 (22 to 153) | 74 (24 to 145) |
| Females | 92 (41 to 155) | 106 (43 to 172) | 97 (35 to 169) | 98 (39 to 167) |
| 0 to 100 | 1008 (55.3) | 1153 (52.7) | 1423 (54.1) | 3584 (53.9) |
| 101 to 200 | 619 (33.9) | 778 (35.5) | 833 (31.7) | 2230 (33.6) |
| 201 to 350 | 156 (8.6) | 212 (9.7) | 299 (11.4) | 667 (10.0) |
| 351 to 500 | 32 (1.8) | 26 (1.2) | 46 (1.7) | 104 (1.6) |
| >500 | 5 (0.3) | 12 (0.5) | 16 (0.6) | 33 (0.5) |
| Missing | 4 (0.2) | 8 (0.4) | 14 (0.5) | 26 (0.4) |
| WHO Stage | ||||
| Stage 1/2 | 1033 (56.6) | 1120 (51.2) | 1347 (51.2) | 3500 (52.7) |
| Males | 281 (50.0) | 293 (40.8) | 440 (46.3) | 1014 (45.5) |
| Females | 752 (59.6) | 827 (56.2) | 907 (54.0) | 2486 (56.3) |
| Stage 3/4 | 791 (43.4) | 1069 (48.8) | 1284 (48.8) | 3144 (47.3) |
| Males | 281 (50.0) | 425 (59.2) | 510 (53.7) | 1216 (54.5) |
| Females | 510 (40.4) | 644 (43.8) | 774 (46.0) | 1928 (43.7) |
| Anaemiab | ||||
| Median (IQR) | 11.5 (10.0 to 12.9) | 11.7 (10.3 to 13.0) | 11.3 (9.8 to 12.8) | 11.5 (9.8 to 13.0) |
| Males | 12.6 (11.0 to 14.1) | 11.8 (10.1 to 13.9) | 12.3 (10.6 to 13.9) | 12.2 (10.5 to 13.9) |
| Females | 11.4 (10.0 to 12.6) | 11.1 (9.8 to 12.4) | 11.1 (9.5 to 12.5) | 11.2 (9.7 to 12.5) |
| None | 730 (40.0) | 731 (33.4) | 932 (35.4) | 2393 (36.0) |
| Mild | 438 (24.0) | 465 (21.2) | 592 (22.5) | 1495 (22.5) |
| Moderate | 556 (30.5) | 801 (36.6) | 901 (34.2) | 2258 (34.0) |
| Severe | 91 (5.0) | 148 (6.8) | 180 (6.8) | 419 (6.3) |
| Missing | 9 (0.5) | 44 (2.0) | 26 (1.0) | 79 (1.2) |
| BMIc | ||||
| Median (IQR) | 21.9 (19.4 to 25.3) | 21.5 (19.0 to 24.8) | 21.6 (19.0 to 24.7) | 21.7 (19.1 to 25.0) |
| Males | 20.5 (18.6 to 22.7) | 19.9 (18.1 to 22.0) | 20.2 (18.5 to 22.4) | 20.2 (18.4 to 22.4) |
| Females | 22.7 (19.9 to 26.2) | 22.8 (19.8 to 26.3) | 22.7 (19.6 to 26.2) | 22.8 (19.7 to 26.2) |
| Underweight | 295 (16.2) | 428 (19.6) | 485 (18.4) | 1208 (18.2) |
| Normal | 929 (50.9) | 1116 (51.0) | 1376 (52.3) | 3421 (51.2) |
| Overweight | 307 (16.8) | 350 (16.0) | 414 (15.7) | 1071 (16.1) |
| Obese | 148 (8.1) | 158 (7.2) | 167 (6.3) | 473 (7.1) |
| Missing | 145 (7.9) | 137 (6.3) | 189 (7.2) | 471 (7.1) |
| TB | 251 (13.8) | 469 (21.4) | 457 (17.4) | 1177 (17.7) |
| Males | 100 (17.8) | 208 (29.0) | 196 (20.6) | 504 (22.6) |
| Females | 151 (12.0) | 261 (17.7) | 261 (15.5) | 673 (15.3) |
| Baseline HAART regimend | ||||
| NRTI | ||||
| Stavudine | 1797 (98.5) | 2117 (96.7) | 2546 (96.8) | 6460 (97.2) |
| Zidovudine | 27 (1.5) | 72 (3.3) | 85 (3.2) | 184 (2.8) |
| NNRTI or PI | ||||
| Efavirenz | 1558 (85.4) | 1769 (80.8) | 2221 (84.4) | 5548 (83.5) |
| Nevirapine | 169 (9.3) | 130 (5.9) | 206 (7.8) | 505 (7.6) |
| Lopinavir‐ritonavir | 97 (5.3) | 290 (13.2) | 204 (7.8) | 591 (8.9) |
| Outcomes on HAART | ||||
| 12‐month outcomes | ||||
| Total person‐years | 1650 | 1918 | 2278 | 5846 |
| Outcomee | ||||
| Alive | 1511 (84.9) | 1707 (78.7) | 1991 (76.5) | 5209 (79.5) |
| Dead | 129 (7.2) | 180 (8.3) | 233 (9.0) | 542 (8.3) |
| Lost to follow‐up | 140 (7.9) | 281 (13.0) | 379 (14.6) | 800 (12.2) |
| Transferred | 44 | 21 | 28 | 93 |
| Attrition rate per 100 person‐years including transfers (95% CI) | 16.3 (14.5 to 18.4) | 24.0 (21.9 to 26.3) | 26.9 (24.8 to 29.1) | 23.0 (21.8 to 24.2) |
| Attrition rate per 100 person‐years excluding transfers (95% CI) | 16.5 (14.6 to 18.6) | 24.1 (22.0 to 26.4) | 27.1 (25.0 to 29.3) | 23.1 (21.9 to 24.4) |
| Median days to attrition (IQR) | 131 (112 to 233) | 137 (122 to 214) | 132 (122 to 230) | 134 (122 to 224) |
| Had a twelve‐month viral load reported | 1198 (65.7) | 1371 (62.6) | 1672 (63.5) | 4241 (63.8) |
| 10‐year outcomes | ||||
| Total person‐years (median; IQR) | 9826 (4.7; 2.1 to 10.0) | 10,248 (3.4; 1.4 to 9.6) | 11,627 (2.9; 1.1 to 9.7) | 31,700 (3.7; 1.4 to 10.0) |
| Outcomee | ||||
| Alive | 509 (39.5) | 537 (33.3) | 648 (33.5) | 1694 (35.1) |
| Dead | 344 (26.7) | 427 (26.5) | 456 (23.6) | 1227 (25.4) |
| Lost to follow‐up | 434 (33.7) | 647 (40.2) | 831 (42.9) | 1912 (39.6) |
| Transferred | 537 | 578 | 696 | 1811 |
| Attrition rate per 100 person‐years including transfers (95% CI) | 7.9 (7.4 to 8.5) | 10.5 (9.9 to 11.1) | 11.1 (10.5 to 11.7) | 9.9 (9.6 to 10.3) |
| Attrition rate per 100 person‐years excluding transfers (95% CI) | 10.4 (9.7 to 11.1) | 13.4 (12.6 to 14.2) | 13.9 (13.1 to 14.7) | 12.7 (12.2 to 13.1) |
| Median months to attrition (IQR) | 24.3 (7.2 to 61.7) | 17.2 (5.0 to 44.2) | 13.3 (4.7 to 40.8) | 17.2 (5.0 to 46.2) |
IQR, interquartile range; BMI, body mass index; WHO, World Health Organization; ART, Antiretroviral therapy; Hb, haemoglobin; CI, confidence interval; PI, protease inhibitor.
Year 1: ART initiated between 1 April 2004 and 31 March 2005; Year 2: ART initiated between 1 April 2005 and 31 March 2006; Year 3: ART initiated between 1 April 2006 and 31 March 2017. Baseline CD4, haemoglobin and BMI were defined as the closest value to the date of ART initiation around a window of 12 months prior to 14 days after.
Anaemia is defined as: none if haemoglobin ≥12 g/dL for females and ≥13 g/dL for males; mild if haemoglobin 11.0 to 11.9 g/dL for females and 11.0 to 12.9 g/dL for males; moderate if haemoglobin between 8.0 and 10.9 g/dL for females and males; and severe if haemoglobin ˂8.0 g/dL for females and males (according to WHO guidelines).
BMI categories are defined as: underweight if calculated BMI is <18.5 kg/m2; normal if BMI is between 18.5 and 24.9 kg/m2; overweight if BMI is between 25.0 and 29.9 kg/m2 and obese if BMI is ≥30.0 kg/m2.
Only standard 2004 ART guideline drugs included.
Denominator excludes those who formally transferred out of care.