Clinical similarities and differences between two large HIV cohorts in the United States and Africa

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dc.contributor.authorMonroe, Anne K.
dc.contributor.authorPolyak, Christina S.
dc.contributor.authorCastel, Amanda D.
dc.contributor.authorEsber, Allahna L.
dc.contributor.authorMaganga, Lucas
dc.contributor.authorKibuuka, Hannah
dc.contributor.authorKiweewa, Francis
dc.contributor.authorAke, Julie A.
dc.date.accessioned2022-12-06T11:18:46Z
dc.date.available2022-12-06T11:18:46Z
dc.date.issued2022
dc.description.abstractWashington, DC, and sub-Saharan Africa are both affected by generalized HIV epidemics. However, care for persons living with HIV (PLWH) and clinical outcomes may differ in these geographically and culturally diverse areas. We compared patient and clinical site characteristics among adult persons living with HIV (PLWH) enrolled in two longitudinal HIV cohort studies—the African Cohort Study (AFRICOS) and the DC Cohort. Methods The DC Cohort is a clinic-based city-wide longitudinal cohort comprised of PLWH attending 15 HIV clinics in Washington, DC. Patients’ socio-demographic characteristics, clinical evaluations, and laboratory data are retrospectively collected from electronic medical records and limited manual chart abstraction. AFRICOS is a prospective observational cohort of PLWH and uninfected volunteers attending 12 select HIV care and treatment facilities in Nigeria, Kenya, Uganda and Tanzania. AFRICOS study participants are a subset of clinic patients who complete protocol-specific visits every 6 months with history and physical examination, questionnaire administration, and blood/sputum collection for ascertainment of HIV outcomes and comorbidities, and neurocognitive and functional assessments. Among participants aged 18 years, we generated descriptive statistics for demographic and clinical characteristics at enrollment and follow up and compared them using bivariable analyses. Results The study sample included 2,774 AFRICOS and 8,420 DC Cohort participants who enrolled from January 2013 (AFRICOS)/January 2011 (DC Cohort) through March 2018. AFRICOS participants were significantly more likely to be women (58.8% vs 27.1%) and younger (83.3% vs 61.1% aged < 50 years old) and significantly less likely to be MSM (only 0.1% of AFRICOS population reported MSM risk factor) than DC Cohort. Similar rates of current viral suppression (about 75% of both samples), hypertension, hepatitis B coinfection and alcohol use were observed. However, AFRICOS participants had significantly higher rates of CD4<200 and tuberculosis and significantly lower rates of obesity, DM, hepatitis C coinfection and syphilis. Conclusions With similar viral suppression outcomes, but many differences between our cohorts noted, the combined sample provides unique opportunities to assess and compare HIV care and treatment outcomes in the U.S. and sub-Saharan Africa. Comparing these two cohorts may inform care and treatment practices and may pave the way for future pathophysiologic analyses.en_US
dc.identifier.citationMonroe AK, Polyak CS, Castel AD, Esber AL, Byrne ME, Maswai J, et al. (2022) Clinical similarities and differences between two large HIV cohorts in the United States and Africa. PLoS ONE 17(4): e0262204. https://doi.org/10.1371/journal. pone.0262204en_US
dc.identifier.urihttps://doi.org/10.1371/journal. pone.0262204
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/5975
dc.language.isoenen_US
dc.publisherPlos oneen_US
dc.subjectClinical similaritiesen_US
dc.subjectHIV cohortsen_US
dc.subjectUnited Statesen_US
dc.subjectAfricaen_US
dc.titleClinical similarities and differences between two large HIV cohorts in the United States and Africaen_US
dc.typeArticleen_US
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