Mortality and morbidity among HIV type-1-infected patients during the first 5 years of a multicountry HIV workplace programme in Africa

Abstract

Background

This study aimed to evaluate the effectiveness of an HIV workplace programme in sub-Saharan Africa.

Methods

The international brewing company, Heineken, introduced an HIV workplace programme in its African subsidiaries in 2001. Beneficiaries from 16 sites in 5 countries were eligible. HIV type-1 (HIV-1)-infected individuals were assessed clinically and immunologically, and started highly active antiretroviral therapy (HAART) if they had AIDS or had a CD4⁺ T-cell count <300 cells/μl. In this cohort, study patients were followed-up for vital status, new AIDS events, CD4⁺ T-cell count and haemoglobin.

Results

Over the first 5 years of the programme, 431 adults were found to be HIV-1-infected. The mortality rate among those not yet taking HAART was 2.6 per 100 person-years of observation (pyo). By October 2006, 249 patients had started HAART at a median CD4⁺ T-cell count of 170 cells/μl; 59 (23.7%) patients were in CDC stage C. Among patients on HAART, 25 died and 7 were lost to follow-up. The mortality rate was 3.7 per 100 pyo overall, 14 per 100 pyo in the first 16 weeks and 2.5 per 100 pyo thereafter (P<0.0001). At 4 years after start of treatment, 89% of patients were known to be alive. The CD4⁺ T-cell count increased by a median of 153 and 238 cells/μl after 1 and 4 years of HAART, respectively.

Conclusions

In this HIV workplace programme in sub-Saharan Africa, long-term high survival was achieved.