Effect of cotrimoxazole on mortality in HIV-infected adults on antiretroviral therapy: a systematic review and meta-analysis
Amitabh B Suthar, Reuben Granich, Jonathan Mermin & Annelies Van Rie
Volume 90, Number 2, February 2012, 128-138C
Table 2. Participants in studies included in systematic review of cotrimoxazole’s effect on mortality and morbidity in adults with human immunodeficiency virus (HIV) infection receiving antiretroviral therapy (ART)
| First author, year | Study country | Inclusion and exclusion criteria for study participants | Percentage of participants with HIV disease at baseline |
Baseline CD4 cell count | BMI or body weight | |
|---|---|---|---|---|---|---|
| WHO stage 3 | WHO stage 4 | |||||
| Walker, 2010 |
Uganda and Zimbabwe | HIV-infected individuals aged ≥ 18 years with WHO stage 2 to 4 disease and a CD4 cell count ≤ 200 cells/µL but with no previous ART were included. Follow-up data from participants whose ART was interrupted were excluded | 56 | 23 | Median CD4 cell count: 83 cells/µL (IQR: 29–137) | Median BMI: 21 kg/m2 (IQR: 19–24) |
| Hoffmann, 2010 |
South Africa | Participants were ≥ 18 years old and ART-naïve at ART initiation. Those with a CD4 cell count < 250 cells/µL, WHO stage 4 disease regardless of CD4 cell count, or WHO stage 3 disease with a CD4 cell count < 350 cells/µL were eligible for ART at workplace clinics. Community clinics required participants to have a CD4 cell count < 200 cells/µL or WHO stage 4 disease for ART | 27 | 35 | Median CD4 cell count at ART initiation: 132 cells/µL (IQR: 60–206) | 16%, 79% and 6% of participants weighed ≤ 60 kg, 61–75 kg and > 75 kg, respectively |
| Lowrance,2007 |
Malawi | Individuals aged ≥ 15 years with WHO stage 3 or 4 disease or a CD4 cell count ≤ 200 cells/µL were included | 63 | 24 | 13% of participants had a CD4 cell count < 200 cells/µL at ART initiation | Not reported |
| Madec, 2007 |
Cambodia | Individuals aged ≥ 13 years with WHO stage 4 disease or a CD4 cell count < 200 cells/µL were included | 45 | 46 | Median CD4cell count at ART initiation: 20 cells/µL (IQR: 6–78) | Median BMI: 18.5 kg/m2 (IQR: 16.6–20.4) in men and 18.7 kg/m2 (IQR: 16.4–21.0) in women |
| Fairall, 2008 |
South Africa | HIV-infected individuals aged ≥ 16 years who had been in contact with the programme at least twice were included | 53 | 11 | 48.4% of participants had a baseline CD4 cell count < 200 cells/µL | Median weight: 55 kg (IQR: 48–64) |
| van Oosterhout, 2010 |
Malawi | ART-naïve individuals aged ≥ 18 years who started ART with a BMI < 18.5 kg/m2 were included. Those who were unable to follow instructions for ART, had active liver disease or were pregnant were excluded | 64 | 28 | Mean CD4 cell count for all participants initiating ART: 132 cells/µL | Mean BMI: 16.5 kg/m2 for all participants initiating ART |
| Alemu, 2010 |
Ethiopia | Participants were ≥ 15 years of age and received ART on at least two clinic visits. Those who started treatment at another location, who had previously received ART, whose baseline CD4 cell count was unknown, or whose personal information was missing were excluded | 54 | 17 | 85% of participants had a CD4 cell count < 200 cells/µL at initiation of ART | 15%, 45%, 30% and 10% of participants weighed ≤ 40 kg, 40–50 kg, 50–60 kg and ≥ 60 kg, respectively |
| Miiro, 2009 |
Uganda | Adults aged ≥ 15 years who had had a WHO stage 4 disease event, who had a recurrent WHO stage 3 disease condition, who had tuberculosis and a CD4 cell count < 350 cells/µL, or who were asymptomatic with a CD4 cell count < 200 cells/µL were included. Those who started ART before joining the cohort or who enrolled in the DART trial were excluded | 34 | 13 | Median CD4 cell count for all participants on ART: 131 cells/µL | Not reported |
| Campbell, 2009 |
Uganda | Ugandans initiated ART if they had a CD4 cell count ≤ 250 cells/µL or WHO stage 3 or 4 disease, excluding pulmonary TB. Ugandans on ART for a mean 3.7 years were randomly assigned, by household, to continue or discontinue cotrimoxazole. For Ugandans randomized to discontinue cotrimoxazole, it was required that their two most recent CD4 cell counts be > 200 cells/µL. | Not reported | Not reported | Median CD4 cell count for all participants: 489 cells/µL. | Not reported |
BMI, body mass index; CD4 cell, CD4+ T lymphocyte; DART, Development of Anti-Retroviral Therapy in Africa; IQR, interquartile range; TB, tuberculosis; WHO, World Health Organization.