Browsing by Author "Appiah, Lambert"

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    High prevalence of renal dysfunction and association with risk of death amongst HIV-infected Ghanaians
    (Elsevier Ltd., 2013-03-28) Phillips, Richard Odame; Shakoor, Shaid; Appiah, Lambert; Keegan, Rosie; Sarfo, Fred Stephen; et.al
    To determine the prevalence of HIV-associated renal dysfunction (RD), identify risk factors for RD and explore the association between baseline renal function and mortality in an HIV-infected population in Ghana. Methods: Creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) was calculated in patients attending an HIV clinic between 2004 and 2011 using Cockcroft-Gault, MDRD and CKD-EPI formulae. Logistic regression analysis was used to identify risk factors associated with RD and KaplaneMeier/Cox proportional regression analyses to explore associations between baseline CrCl/eGFR and subsequent mortality. Results: In 3137 patients starting antiretroviral therapy (ART) the frequency (95%-CI) of RD, defined by CrCl <60 ml/min/1.73 m2 using Cockroft-Gault formula was 38.8% (37.1e40.5%). RD prevalence in a sub-population of 238 patients, including proteinuria in the definition, was 15.3% (10.3e22.1%) in ART-treated and 43.6% (34.0e53.7%) in ART-na€ıve patients. RD at baseline was associated with increasing age, low CD4 counts, advanced WHO stage and female gender. Cox proportional hazard analysis identified an increased hazard of death with decreasing CrCl, HR 1.46 (1.31e1.63) for each tertile lower than CrCl of 90 ml/min/1.73 m2. Conclusions: RD is very common in HIV-infected ART-na€ıve Ghanaians, and associated with increased risk of mortality. Screening and monitoring of RD is important in this setting, particularly as tenofovir use increases.
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    Response to antiretroviral therapy in occult hepatitis B and HIV co-infection in West Africa
    (Lippincott Williams & Wilkins, 2013) Chadwick, David; Phillips, Richard Odame; Stanley, Alastair; Sarfo, Fred Stephen; Appiah, Lambert; et. al
    This study evaluated the outcome of first-line antiretroviral therapy among 35 Ghanaians with occult HBV/HIV co-infection, comparing them over 2 years to 120 patients with HBsAgR HBV/HIV co-infection and 230 patients without HBV coinfection. Increases in CD4 cell count and BMI were similar, whereas elevations of hepatic transaminases were more frequent in both the occult HBVand HBsAgR patients. Occult HBV/HIV coinfection appears not to impact adversely on response to antiretroviral therapy in Ghana.