@article{fdi:010058933,
  title = {{W}omen experience a better long-term immune recovery and a better survival on {HAART} in {L}ao {P}eople's {D}emocratic {R}epublic},
  author = {{B}astard, {M}. and {S}oulinphumy, {K}. and {P}himmasone, {P}. and {S}aadani, {A}. {H}. and {C}iaffi, {L}. and {C}ommunier, {A}. and {P}himphachanh, {C}. and {E}cochard, {R}. and {E}tard, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}n {A}pril 2003, {M}edecins {S}ans {F}rontieres launched an {HIV}/{AIDS} programme to provide free {HAART} to {HIV}-infected patients in {L}aos. {A}lthough {HIV} prevalence is estimated as low in this country, it has been increasing in the last years. {T}his work reports the first results of an observational cohort study and it aims to identify the principal determinants of the {CD}4 cells evolution and to assess mortality among patients on {HAART}. {M}ethods: {W}e performed a retrospective database analysis on patients initiated on {HAART} between 2003 and 2009 ({CD}4<200cells/mu {L} or {WHO} stage 4). {W}e excluded from the analysis patients who were less than 16 years old and pregnant women. {T}o explore the determinants of the {CD}4 reconstitution, a linear mixed model was adjusted. {T}o identify typical trajectories of the {CD}4 cells, a latent trajectory analysis was carried out. {F}inally, a {C}ox proportional-hazards model was used to reveal predictors of mortality on {HAART} including appointment delay greater than 1 day. {R}esults: {A} total of 1365 patients entered the programme and 913 (66.9%) received an {HAART} with a median {CD}4 of 49 cells/mu {L} [{IQR} 15-148]. {H}igh baseline {CD}4 cell count and female gender were associated with a higher {CD}4 level over time. {I}n addition, this gender difference increased over time. {T}wo typical latent {CD}4 trajectories were revealed showing that 31% of women against 22% of men followed a high {CD}4 trajectory. {I}n the long-term, women were more likely to attend appointments without delay. {M}ortality reached 6.2% (95% {CI} 4.8-8.0%) at 4 months and 9.1% (95% {CI} 7.3-11.3%) at 1 year. {F}emale gender ({HR}=0.17, 95% {CI} 0.07-0.44) and high {CD}4 trajectory ({HR}=0.19, 95% {CI} 0.08-0.47) were independently associated with a lower death rate. {C}onclusions: {P}atients who initiated {HAART} were severely immunocompromised yielding to a high early mortality. {I}n the long-term on {HAART}, women achieved a better {CD}4 cells reconstitution than men and were less likely to die. {T}his study highlights important differences between men and women regarding response to {HAART} and medical care, and questions men's compliance to treatment.},
  keywords = {{LAOS}},
  booktitle = {},
  journal = {{B}mc {I}nfectious {D}iseases},
  volume = {13},
  numero = {},
  pages = {27},
  ISSN = {1471-2334},
  year = {2013},
  DOI = {10.1186/1471-2334-13-27},
  URL = {https://www.documentation.ird.fr/hor/fdi:010058933},
}