Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts

A. I. Abioye, A. I. Soipe, A. A. Salako, M. O. Odesanya, T. A. Okuneye, A. I. Abioye, K. A. Ismail, M. O. Omotayo

Research output: Contribution to journalArticle

Abstract

Studies examining the sex differences in morbidity and mortality among HIV/AIDS patients have yielded inconsistent results. We conducted a meta-analysis of sex differences in disease progression and mortality among HIV/AIDS patients. Medical literature databases from inception to August 2014 were searched for published observational studies assessing sex differences in immunologic and virologic response, disease progression and mortality among HIV-infected patients. Random effects meta-analyses of 115 eligible studies were conducted to obtain pooled estimates of outcomes and heterogeneity was explored in sub-group analyses. Pooled estimates showed an increased risk of progression to AIDS (relative risk [RR]=1.11,95% CI=1.02-1.21) and all-cause mortality (RR=1.23, 95% CI=1.17-1.29) among males compared to females. All-cause mortality differed by sex only in low and middle income countries. The risk of AIDS-related mortality (RR=1.03, 95% CI=0.82-1.30), immunologic failure (RR=1.19,95% CI: 0.97-1.47), virologic suppression (RR=0.98, 95% CI=0.84-1.14), virologic failure (RR=1.26, 95% CI=0.99-1.61) and the change in CD4 cell count (Weighted mean difference [WMD] = -5.15, 95% CI= -13.57 to 3.28) did not differ by sex. These findings were modified by disease severity, adherence and use of highly active antiretroviral therapy. We conclude that HIV-related disease progression and survival outcomes are poorer in males.

Original languageEnglish
Pages (from-to)1468-1486
Number of pages19
JournalAids Care: Psychological and Socio-Medical Aspects of Aids-Hiv
Volume27
Issue number12
DOIs
Publication statusPublished - 2 Dec 2015

Fingerprint

Disease Progression
Meta-Analysis
mortality
HIV
Disease
Mortality
Acquired Immunodeficiency Syndrome
AIDS
Sex Characteristics
Therapeutics
cause
Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
suppression
morbidity
Observational Studies
Databases
Morbidity
income
Survival

Keywords

  • antiretroviral therapy
  • CD4 cell count
  • gender
  • HIV/AIDS
  • mortality
  • viral load

Cite this

Abioye, A. I. ; Soipe, A. I. ; Salako, A. A. ; Odesanya, M. O. ; Okuneye, T. A. ; Abioye, A. I. ; Ismail, K. A. ; Omotayo, M. O. / Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts. In: Aids Care: Psychological and Socio-Medical Aspects of Aids-Hiv . 2015 ; Vol. 27, No. 12. pp. 1468-1486.
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Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts. / Abioye, A. I.; Soipe, A. I.; Salako, A. A.; Odesanya, M. O.; Okuneye, T. A.; Abioye, A. I.; Ismail, K. A.; Omotayo, M. O.

In: Aids Care: Psychological and Socio-Medical Aspects of Aids-Hiv , Vol. 27, No. 12, 02.12.2015, p. 1468-1486.

Research output: Contribution to journalArticle

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T1 - Are there differences in disease progression and mortality among male and female HIV patients on antiretroviral therapy? A meta-analysis of observational cohorts

AU - Abioye, A. I.

AU - Soipe, A. I.

AU - Salako, A. A.

AU - Odesanya, M. O.

AU - Okuneye, T. A.

AU - Abioye, A. I.

AU - Ismail, K. A.

AU - Omotayo, M. O.

PY - 2015/12/2

Y1 - 2015/12/2

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AB - Studies examining the sex differences in morbidity and mortality among HIV/AIDS patients have yielded inconsistent results. We conducted a meta-analysis of sex differences in disease progression and mortality among HIV/AIDS patients. Medical literature databases from inception to August 2014 were searched for published observational studies assessing sex differences in immunologic and virologic response, disease progression and mortality among HIV-infected patients. Random effects meta-analyses of 115 eligible studies were conducted to obtain pooled estimates of outcomes and heterogeneity was explored in sub-group analyses. Pooled estimates showed an increased risk of progression to AIDS (relative risk [RR]=1.11,95% CI=1.02-1.21) and all-cause mortality (RR=1.23, 95% CI=1.17-1.29) among males compared to females. All-cause mortality differed by sex only in low and middle income countries. The risk of AIDS-related mortality (RR=1.03, 95% CI=0.82-1.30), immunologic failure (RR=1.19,95% CI: 0.97-1.47), virologic suppression (RR=0.98, 95% CI=0.84-1.14), virologic failure (RR=1.26, 95% CI=0.99-1.61) and the change in CD4 cell count (Weighted mean difference [WMD] = -5.15, 95% CI= -13.57 to 3.28) did not differ by sex. These findings were modified by disease severity, adherence and use of highly active antiretroviral therapy. We conclude that HIV-related disease progression and survival outcomes are poorer in males.

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