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In This Issue, Clinical Infectious Diseases, Volume 43, Issue 6, 15 September 2006, Page i, https://doi.org/10.1086/507470
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Mortality and losses from an antiretroviral therapy (ART) program (Lawn et al., pp. 770–6). Because the efficacy of ART is similar among patients treated in wealthy countries and patients treated in developing countries, the impact of ART programs in low-income countries is likely to be related to health system issues and program effectiveness. In a study involving 927 patients who had initiated ART in a program in South Africa, mortality rates were 33 deaths per 100 person-years before treatment, 19 deaths per 100 person-years in the first 4 months of treatment, and 3 deaths per 100 person-years thereafter (see figure). The high mortality rates before treatment and in the first 4 months of treatment suggest that many patients who are enrolling in ART programs have advanced immunodeficiency, and reasons for late access to the program need to be identified.
Long-term outcomes for patients with West Nile virus infection (Carson et al., pp. 723–30). Since its introduction in 1999, West Nile virus infection has become the most common arboviral infection in North America. Forty-nine patients with laboratory-confirmed cases of West Nile virus infection were assessed for persisting deficits in neurologic and cognitive function a median of 13 months after receiving a diagnosis. In addition, standardized surveys for quality of life, functional ability, fatigue, and depression were performed. Multiple somatic complaints, tremor, and abnormalities in motor skills and executive functions were common long-term problems after West Nile virus infection. Patients with milder illness were just as likely as patients with more-severe illness to experience adverse outcomes.
