Table 1.
Incidence rates for opportunistic illnesses among HIV-infected individuals from high and low/middle-income settings.
| First author, year, journal | Setting and cohort (when applicable) | Time period evaluated | Incidence rate estimate | Notes |
|---|---|---|---|---|
| High-income settings | ||||
| Cain, 2009, American Journal of Epidemiology | Baltimore, Pittsburgh, Chicago and Los Angeles, US, MACS cohort | 1984a to April 2007 | Entire period: 5.23/100 PY; Before 1996: 7.53/100 PY; After1996: 2.19/100 PY | Patient inclusion criteria: no CD4 criteria, MSM only; Disease definition: CDC 1993, considers only the first ADI after cohort enrollment |
| Mocroft, 1999, Journal of Acquired Immune Deficiency Syndromes | London, UK, Royal Free Center for HIV Medicine | 1987a to 1998a | Before 1992: 27.4/100 PY; 1992–1993: 16.8/100 PY; 1994: 17.9/100 PY; 1995: 19.3/100 PY; 1996: 16.7/100 PY; 1997: 6.9/100 PY | Patient inclusion criteria: no CD4 criteria; Disease definition: CDC 1993, considers only the first ADI after cohort enrollment |
| San-Andres, 2003, Clinical Infectious Diseases | Madrid, Spain, University Hospital | January 1989–1997a | 1989–1991: 36.4/100 PY; 1992: 43.2/100 PY; 1993: 39.0/100 PY; 1994: 32.4/100 PY; 1995: 32.0/100 PY; 1996: 30.9/100 PY; 1997: 14.6/100 PY | Patient inclusion criteria: CD4 less than 500 cells/mm3 or previous AIDS diagnosis; Disease definition: not clearly stated, likely considers all ADIb episodes after cohort enrollment |
| Charurat, 2004, Journal of Women's Health | 4 states in US and Puerto Rico, WITS Cohort | December 1989 to June 2002 | Before Feb/1994: 4.52/100 PY; Mar/1994 to Jul/1996: 5.09/100 PY; After Aug/1996: 1.22/100 PY | Patient inclusion criteria: no CD4 criteria, only women without previous diagnosis of AIDS; Disease definition: CDC 1993; considers only the first ADI after cohort enrollment |
| Kaplan, 2000, Clinical Infectious Diseases | 10 US cities, Adults/Adolescents Spectrum of HIV Disease (ASD) Study | 1992a to September 1999 | 1996–1998: 16/100 PYc | Patient inclusion criteria: no CD4 criteria; Disease definition: not clearly stated, likely considers all ADId episodes after cohort enrollment |
| Forrest, 1998, Clinical Infectious Diseases | British Columbia, Canada, British Columbia Center for Excellence in HIV/AIDS | January 1994 to December 1996 | 1994: 8/100 PY; 1996: 2.2/100 PY | Patient inclusion criteria: no CD4 criteria, included only patients in use of antiretroviral drugs; Disease definition: CDC 1993; considers only the first ADI after cohort enrollment |
| Mocroft, 2000, Lancet | 51 centers in Europe, Eurosida cohort | May 1994 to spring 1999a | 1994: 30.7/100 PY; 1998: 2.5/100 PYc | Patient inclusion criteria: CD4 < 500 cells/mm3; Disease definition: CDC 1993, considers the first ADI after cohort enrollment |
| Buchacz, 2010, AIDS | 12 centers in US, HOPS cohort | January 1994 to December 2007 | 1994–1997: 9.24/100 PY; 1998–2002: 2.96/100 PY; 2003–2007: 1.66/100 PY | Patient inclusion criteria: no CD4 criteria; Disease definition: CDC 1993e; considers only the first ADI after cohort enrollment |
| Ledergerber, 1999, Journal of the American Medical Association | 7 centers in Switzerland, Swiss HIV Cohort Study | September 1995 to March 1999 | Before to ART use: 15.1/100 PY; after ART use: 3.57/100 PY | Patient inclusion criteria: no CD4 criteria, included patients who started ART between September 1995 and December 1997. Disease definition: CDC 1993, considers only the first ADI after cohort enrollment |
| Wohl, 2003, Aids Patient Care and STDs | 10 US cities, ASD cohort | 1996a to 2000a | US born: 21.0/100 PY; Mexican born: 16.6/100 PY; Central American born: 13.9/100 PY | Patient inclusion criteria: no CD4 criteria; included US born Latinos, Mexican born Latinos and Central American Latinos. Disease definition: not clear stated, apparently included all ADI presented in the study period. |
| Plettenberg, 2011, Infection | Germany, KompNet cohort | 1996a to 2010f | Group 1: 1.38/100 PY; Group 2: 0.78/100 PY | Patient inclusion criteria: patients who started antiretroviral treatment.g Disease definition: included the first episode of an ADI after antiretroviral therapy. |
| Low/middle-income settings | ||||
| Fonseca, 1999, International Journal of Epidemiology | São Paulo, Brazil, University of São Paulo | 1986a to June 1997 | 12.24/100 PY (converted from 10.2/1000 PM) | Patient inclusion criteria: asymptomatic patients; Disease definition: CDC 1987, modified to include pulmonary tuberculosis as an AIDS defining-condition, considers only the first ADI after cohort enrollment |
| Casseb, 2003, AIDS Patient care and STDs | São Paulo, Brazil, University of São Paulo | October 1987 to February 2002 | 4.6/100 PY (converted from 3.84/1000PM) | Patient inclusion criteria: asymptomatic patients; Disease definition: CDC 1987, considers only the first ADI after cohort enrollment |
| Badri, 2005, The Southern African Journal of HIV Medicine | Cape Town, South Africa, Cape Town AIDS Cohort (CTAC) | 1992a to December 2000 | 21.34/100 PY | Patient inclusion criteria: no CD4 criteria; Disease definition: WHO 1990, considers all ADI episodes after cohort enrollment |
| Losina, 2007, Antiviral Therapy | Abidjan, Ivory Coast, Cotrimo CI ANRS 059 and Cotrame ANRS1203 | 1996a to July 2003 | Cotrimoxazole alone: CD4 less than 50 cells/mm3: 20.17/100 PY; CD4 above 200 cells/mm3: 3.54/100 PY; Cotrimoxazole plus ART (0–6 months): CD4 less 50 cells/mm3: 20.22/100 PY, CD4 > 200 cells/mm3: 2.79/100 PY; Cotrimoxazole plus ART (>6 months): CD4 < 50 cells/mm3: 6.84/100 PY, CD4 > 200 cells/mm3: 1.68/100 PY | Patient inclusion: Patients participating in Cotrimo ANRS and Cotrame ANRS studies. Disease definition: considers only the first ADIh presented in each periodi of study. Results were stratified by use of cotrimoxazole prophylaxis, ART and CD4 counts. |
| Gadelha, 2002, Rev Inst Med Trop Sao Paulo | Rio de Janeiro, Brazil, IPEC cohort | September 1997 to December 1999 | 29/100 PYj | Patient inclusion criteria: at least one CD4 < 100 cells/mm3, included patients who started ART between September 1995 and December 1997. Disease definition: CDC 1993, considers the first ADI after cohort enrollment |
| De Beaudrap, 2010, BMC Infectious Diseases | Senegal, Initative Sénégalaise d’Acèss aux médicaments Antiretrovirauxk | August 1998 to April 2008 | First year after ART initiation: 20.5/100 PY. Over the fourth year after ART initiation: 4.3/100 PY | Patient inclusion criteria: no CD4 criteria. Disease definition: CDC 1993, considered the first episode of each ADI presented after ART initiation. Results were stratified by timing of ART use |
| Podlasin, 2006, Infection | 10 centers in Poland | 2000a to 2002a | Total: 2.4/100 PY; 2000: 6.8/100 PY; 2001: 6.5/100 PY; 2002: 4.8/100 PY | Patient inclusion criteria: none; Disease definition: CDC 1993, not clearly stated, likely considers all ADI after cohort enrollment |
| Rojanawiwat, 2011, International Health | Lampang, Thailand, Governmental Referral Hospitall | July 2000 to October 2004 | Prior to ART: 19.1/100 PY; After ART use: 8.2/100 PY | Patient inclusion criteria: no CD4 criteria; Disease definition: included the first episode of all ADIm presented by the patient |
ADI: AIDS defining illness; CDC: Centers for Disease Control; CMV: cytomegalovirus; MAC: Mycobacterium avium complex; MSM: men who have sex with men; PCP: Pneumocystis carinii pneumonia.
Month not specified.
Does not specify the criteria used for ADI, the results include: Esophageal candidiasis, PCP, tuberculosis, wasting syndrome, cerebral toxoplasmosis, Kaposi's sarcoma, AIDS dementia complex, progressive multifocal leukoencephalopathy, primary brain lymphoma, CMV disease, MAC, non-Hodgkin lymphoma, cryptosporidiosis, recurrent pneumonia, cryptococcosis, chronic herpes simplex, invasive cervical cancer.
Results for other years shown in figure format only, thus not reported here.
Diseases included: PCP, disseminated MAC, cerebral toxoplasmosis, Kaposi's sarcoma, CMV retinitis, esophageal candidiasis, cryptococcosis.
Excluded diseases: recurrent pneumonia, Salmonella septicemia and wasting syndrome.
Time inferred from information contained in the text.
Patients were separated into two groups: Group 1: patients who started ART with CD4 between 250 and 349 cells/mm3; Group 2: patients who started ART with CD4 between 350 and 450 cells/mm3.
Diseases included: severe bacterial infections (pneumonia, enteritis, bacteremia, invasive urogenital infection), malaria, cerebral toxoplasmosis, isosporosis, PCP, extrapulmonar cryptococosis, esophageal candidiasis, tuberculosis, MAC, other WHO clinical stage 3 and 4.
In the first period (until December 1998), patients received cotrimoxazole prophylaxis. In the second period (after December 1998) patients received ART plus cotrimoxazole prophylaxis (the later period was separated in the first 6 months after ART initiation and after 6 months of ART initiation).
Data from de prospective period.
Antiretroviral drugs available for free since December 2003.
In 2002 the government introduced the co-formulation stavudine, lamivudine and nevirapine (on a pilot basis). The use of this medication gradually increased especially after 2004.
Does not specify the criteria used for ADI, the results include: tuberculosis, PCP, cryptococcal meningitis, penicilliosis, esophageal candidiasis, herpes zoster, cerebral toxoplasmosis, CMV retinitis.