The AIDS Support Organization

About: The AIDS Support Organization is a nonprofit organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Acquired immunodeficiency syndrome (AIDS). The organization has 71 authors who have published 90 publications receiving 6103 citations.

Antiretroviral prophylaxis for HIV prevention in heterosexual men and women.

Abstract: Background Antiretroviral preexposure prophylaxis is a promising approach for preventing human immunodeficiency virus type 1 (HIV-1) infection in heterosexual populations. Methods We conducted a randomized trial of oral antiretroviral therapy for use as preexposure prophylaxis among HIV-1–serodiscordant heterosexual couples from Kenya and Uganda. The HIV-1–seronegative partner in each couple was randomly assigned to one of three study regimens — once-daily tenofovir (TDF), combination tenofovir–emtricitabine (TDF–FTC), or matching placebo — and followed monthly for up to 36 months. At enrollment, the HIV-1–seropositive partners were not eligible for antiretroviral therapy, according to national guidelines. All couples received standard HIV-1 treatment and prevention services. Results We enrolled 4758 couples, of whom 4747 were followed: 1584 randomly assigned to TDF, 1579 to TDF–FTC, and 1584 to placebo. For 62% of the couples followed, the HIV-1–seronegative partner was male. Among HIV-1–seropositive par...

Life Expectancy of Persons Receiving Combination Antiretroviral Therapy in Low-Income Countries: A Cohort Analysis From Uganda

Abstract: BACKGROUND: Little is known about the effect of combination antiretroviral therapy (cART) on life expectancy in sub-Saharan Africa. OBJECTIVE: To estimate life expectancy of patients once they initiate cART in Uganda. DESIGN: Prospective cohort study. SETTING: Public sector HIV and AIDS disease-management program in Uganda. PATIENTS: 22 315 eligible patients initiated cART during the study period of whom 1943 were considered to have died. MEASUREMENTS: All-cause mortality rates were calculated and abridged life tables were constructed and stratified by sex and baseline CD4 cell count status to estimate life expectancies for patients receiving cART. The average number of years remaining to be lived by patients who received cART at varying age categories was estimated. RESULTS: After adjustment for loss to follow-up crude mortality rates (deaths per 1000 person-years) ranged from 26.9 (95% CI 25.4 to 28.5) in women to 43.9 (CI 40.7 to 47.0) in men. For patients with a baseline CD4 cell count less than 0.050 x 10(9) cells/L the mortality rate was 67.3 (CI 62.1 to 72.9) deaths per 1000 person-years whereas among persons with a baseline CD4 cell count of 0.250 x 10(9) cells/L or more the mortality rate was 19.1 (CI 16.0 to 22.7) deaths per 1000 person-years. Life expectancy at age 20 years for the overall cohort was 26.7 (CI 25.0 to 28.4) additional years and at age 35 years was 27.9 (CI 26.7 to 29.1) additional years. Life expectancy increased substantially with increasing baseline CD4 cell count. Similar trends are observed for older age groups. LIMITATIONS: A small (6.4%) proportion of patients were lost to follow-up and it was imputed that 30% of these patients had died. Few patients with a CD4 cell count greater than 0.250 x 10(9) cells/L initiated cART. CONCLUSION: Ugandan patients receiving cART can expect an almost normal life expectancy although there is considerable variability among subgroups of patients. PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research.

Spectrum of cancers among HIV-infected persons in Africa: The Uganda AIDS-Cancer Registry Match Study

Abstract: Although more than 25 million people in sub-Saharan Africa have human immunodeficiency virus (HIV) infection, little is known regarding their cancer risk. We investigated cancer risk among persons with HIV/AIDS in Uganda using record-linkage. We linked records of 12,607 HIV-infected persons attending The AIDS Support Organization (TASO) in Kyadondo County from October 1988 through December 2002 to the Kampala Cancer Registry. We calculated standardized incidence ratios (SIRs) to identify increased cancer risks in the early (4-27 months after TASO registration), late (28-60 months), or combined (4-60 months) incidence periods. We identified 378 cancers (181 prevalent, 197 incident) among TASO participants. Of incident cancers, 137 (70%) were AIDS-defining cancers. Risk was increased in the early-incident period, compared to the general population, for the AIDS-defining cancers: Kaposi sarcoma (SIR 6.4, 95%CI 4.8-8.4), non-Hodgkin lymphoma (6.7, 1.8-17), and cervical carcinoma (2.4, 1.1-4.4). These three cancers were also increased in the combined periods. Risks of five non-AIDS-defining cancers were increased in the combined periods: Hodgkin lymphoma (5.7, 1.2-17) and cancers of the conjunctiva (SIR 4.0; 1.5-8.7), kidney (16, 1.8-58), thyroid (5.7, 1.1-16), and uterus (5.5, 1.5-14). Cancers of the breast, nasopharynx, and lung were increased either in the early or late incident periods only. Among 407 children, seven cancers were observed, of which five were Kaposi sarcoma. The application of a record-linkage design in Africa broadens the repertoire of epidemiological tools for studying HIV-infected populations. We confirm the increased risks of AIDS-defining cancers and report increased risks of a few non-AIDS-defining cancers.