Volume 83, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Since February 2002, the Drug Resources Enhancement against AIDS and Malnutrition Program has provided highly active antiretroviral therapy (HAART) and immunologic and virologic monitoring free of charge. We conducted a cohort study of persons infected with human immunodeficiency virus in Mozambique. Only persons treated with HAART with available CD4 cell counts at baseline and ≥ 1 CD4 cell count after HAART were included. Survival analysis was applied to evaluate the prognostic value of CD4 cell counts measured at three months. Possible confounders were considered. A total of 753 persons who started HAART included; 59% were females. Median age was 34 years (range = 16–67 years), and the median CD4 cell count at baseline was 172 cells/mm (interquartile range = 87–261 cells/mm , range = 0–1,322 cells/mm ). Overall, 105 persons (14%) died. Of these persons 54 (51%) developed AIDS before they died; 25 (3%) died during the first three months. After three months of therapy, the individual median CD4 cell count change from the baseline value was +101 cells/mm (interquartile range = +27 to +187 cells/mm , range = –723 to +310 cells/mm ). A median CD4 increment of 100 cells/mm in three months was associated with a mortality reduction of 50% compared with an increase of < 50 cells (relative hazard of death adjusted for baseline CD4 cell count = 0.54, 95% confidence interval = 0.30–0.95). A good initial response to HAART was associated with a significant reduction of mortality. This finding supports the effectiveness of HAART in resource-poor settings.


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  • Received : 26 Nov 2009
  • Accepted : 16 Mar 2010
  • Published online : 05 Nov 2010

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