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 language | English |
|---|---|
| Pages (from-to) | 1468-1486 |
| Number of pages | 19 |
| Journal | Aids Care: Psychological and Socio-Medical Aspects of Aids-Hiv |
| Volume | 27 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2 Dec 2015 |
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Keywords
- antiretroviral therapy
- CD4 cell count
- gender
- HIV/AIDS
- mortality
- viral load
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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 journal › Article
TY - JOUR
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
N2 - 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.
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.
KW - antiretroviral therapy
KW - CD4 cell count
KW - gender
KW - HIV/AIDS
KW - mortality
KW - viral load
UR - http://www.scopus.com/inward/record.url?scp=84951740207&partnerID=8YFLogxK
U2 - 10.1080/09540121.2015.1114994
DO - 10.1080/09540121.2015.1114994
M3 - Article
AN - SCOPUS:84951740207
VL - 27
SP - 1468
EP - 1486
JO - Aids Care: Psychological and Socio-Medical Aspects of Aids-Hiv
JF - Aids Care: Psychological and Socio-Medical Aspects of Aids-Hiv
SN - 0954-0121
IS - 12
ER -