Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL), Monrovia, Liberia.
John F Kennedy Medical Center, Monrovia, Liberia.
PLoS One. 2021 Sep 10;16(9):e0257049. doi: 10.1371/journal.pone.0257049. eCollection 2021.
Detailed longitudinal studies of HIV-positive individuals in West Africa are lacking. Here the HIV prevalence, incidence, all-cause mortality, and the proportion of individuals receiving treatment with cART in two cohorts of participants in Ebola-related studies are described.
Individuals of all ages were enrolled and followed at four sites in the area of Monrovia, Liberia.
Two cohorts identified in response to the Ebola epidemic are described to provide insights into the current state of the HIV epidemic. HIV testing was performed at baseline for participants in both cohorts and during follow-up in one cohort.
Prevalence and incidence of HIV (prevalence of 3.1% for women and 1.4% for men and incidence of 3.3 per 1,000) were higher in these cohorts compared to 2018 national estimates (prevalence of 1.3% and incidence of 0.39 per 1,000). Most participants testing positive did not know their status prior to testing. Of those who knew they were HIV positive, 7.9% reported being on antiretroviral treatment. The death rate among those with HIV was 12.3% compared to 1.9% in HIV-negative individuals (adjusted odds ratio of 6.87). While higher levels of d-dimer were associated with increased mortality, this was not specific to those with HIV, however lower hemoglobin levels were associated with increased mortality among those with HIV.
These findings point to a need to perform further research studies aimed at fulfilling these knowledge gaps and address current shortcomings in the provision of care for those living with HIV in Liberia.
缺乏对西非 HIV 阳性个体的详细纵向研究。本研究描述了在利比里亚蒙罗维亚地区的四个地点参与埃博拉相关研究的两个队列中的 HIV 流行率、发病率、全因死亡率以及接受 cART 治疗的个体比例。
所有年龄段的个体均被招募并在利比里亚蒙罗维亚地区的四个地点进行随访。
为了深入了解 HIV 流行现状，我们描述了针对埃博拉疫情而确定的两个队列。两个队列的参与者均在基线时进行了 HIV 检测，其中一个队列在随访期间也进行了 HIV 检测。
与 2018 年全国估计值相比（流行率为 1.3%，发病率为 0.39/1000），这些队列中的 HIV 流行率（女性流行率为 3.1%，男性流行率为 1.4%）和发病率（发病率为 3.3/1000）更高。大多数检测呈阳性的参与者在检测前并不知道自己的状况。在那些知道自己 HIV 阳性的人中，有 7.9%的人报告正在接受抗逆转录病毒治疗。HIV 阳性者的死亡率为 12.3%，而 HIV 阴性者的死亡率为 1.9%（调整后的优势比为 6.87）。虽然较高的 D-二聚体水平与死亡率增加相关，但这并非 HIV 阳性者所特有，然而，较低的血红蛋白水平与 HIV 阳性者的死亡率增加有关。
这些发现表明需要进一步开展研究，以填补这些知识空白，并解决利比里亚为 HIV 感染者提供护理方面的当前不足。
