Trends in demographic and clinical characteristics of patients enrolled in HIV care and subsequent Antiretroviral Therapy initiation in the Central Africa International epidemiology Database to Evaluate AIDS (CA-IeDEA) Adult Cohort 2004-2018.

BackgroundThe Central Africa International epidemiology Database to Evaluate AIDS (CA-IeDEA) is a prospective study investigating impact, progression and long-term outcomes of HIV/AIDS among people living with HIV (PLWH) in Burundi, Cameroon, Democratic Republic of Congo (DRC), Republic of Congo (ROC) and Rwanda. We described trends in baseline demographic, clinical and immunological characteristics of patients aged >15 years entering into HIV care in the participating CA-IeDEA site and subsequent ART initiation. Materials and MethodsInformation on socio-demographic characteristics, height, weight, body mass index (BMI), CD4 cell count, WHO staging and ART status at entry into care from 2004 to 2018 were extracted from clinic records of patients aged >15 years enrolling in HIV care at participating clinics in Burundi, Cameroon, DRC, ROC and Rwanda. We assessed trends in patient characteristics at enrollment in HIV care and ART initiation at the participating site and calculated proportions, means and medians (interquartile ranges) for the main variables of interest. ResultsAmong 69,176 participants in the CA-IeDEA cohort, 39% % were from Rwanda,, 24% from ROC, 18% from Cameroon, 14% from Burundi and 5% from DRC. More women (66%) than men were enrolled in care and subsequently initiated ART. Women were also younger (32 years) than men (38 years) (p= <0.001) when they enrolled in care or subsequently initiated ART at the participating site. Trends over time show increases in median CD4 cell count of 190 cells/uL in 2004 to 334 cells/uL in 2018 at enrollment. Among those with complete data on CD4 counts (60%), women had higher median CD4 cell count at care entry in the CA-IeDEA site (299 cells/uL) versus men (249 cells/uL; p= < 0.001).Trends in proportion of patients using ART show an increase from 16% in 2004 to 75% in 2018 among those initiating ART for the first time after entry into care in the participating site. As expected, median CD4 generally increased after ART initiation (p= <0.001). ConclusionTrends from 2004-2018 in the characteristics of patients participating in the CA-IeDEA cohort highlight improvements over time at entry into care and subsequent ART in all participating sites.