Seguimiento prospectivo de una población infectada por VIH con y sin posibilidades de terapia anti retroviral: impacto en sobrevida y complicaciones / Prospective follow up of HIV positive patients with and without access to antiretroviral therapy: survival and complications
Rev. méd. Chile
; 129(8): 886-894, ago. 2001. tab, graf
Article
en Es
| LILACS
| ID: lil-300149
Biblioteca responsable:
CL1.1
ABSTRACT
Background:
Three-drug antiretroviral therapy (ART-3) has reduced complications and improved survival in HIV+ patients. The Chilean Public Health System began dual therapy (ART-2) in 1997, covering approximately 40 percent of patients in need.Aim:
To report the results of a follow-up of patients with and without access to ART in a Chilean public hospital. Patient andMethods:
Prospective follow-up of patients with ART-2 and 3 (cases) and patients with no access to ART (controls). All patients needed ART but it was available to a minority of them. Selection for ART was at random. Follow-up was between 6-24 months (11/96 to 3/99). Basal and periodic clinical and laboratory parameters were determined. Mortality and occurrence of new AIDS-defining events (ADE) were compared statistically using chi square.Results:
One hundred and fifty cases (106 ART2, 28 ART3 and 16 ART2 expanded to ART3) and 166 controls were studied. Basal parameters were similar except prior ART (32.7 and 18.7 percent in cases and controls respectively). Close to 1/3 patients had AIDS. Cases had a mean follow up of 527 days; controls, 478. Six cases (4 percent) (5 in ART-2) and 17 controls (10 percent) died. Mortality x 100/pts/yr was 2.7 in cases and 7.7 in controls, p <0.05. ADE per 100/pts/yr was 21 in cases (24.4 in ART2, 15.1 in TAR3) and 54.5 in controls, p <0.05. Cases had a reduction of esophageal candidiasis (84 percent), tuberculosis (75 percent), cryptococcosis and toxoplasmosis (66 percent), P carinii pneumonia (55 percent) and bacterial pneumonia (46 percent) and they had fewer hospitalizations (73 percent). Late assessment 70 of 101 ART-2 patients had changed to ART-3 (1 death); 22 of 101 kept original ART-2 (12 dead, 10 alive), 39 of 43 ART-3 patients were alive and 1 died.Conclusions:
Short-term ART-2 and 3 significantly reduced mortality (60 percent and 73 percent) ADE (65 percent and 76 percent respectively) and hospitalizations. Benefits of ART-2 were short lived. Resource-constrained countries cannot depend on weaker than standard ART for proper care of people with HIV disease
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Zidovudina
/
Síndrome de Inmunodeficiencia Adquirida
/
Lamivudine
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Idioma:
Es
Revista:
Rev. méd. Chile
Asunto de la revista:
MEDICINA
Año:
2001
Tipo del documento:
Article
/
Congress and conference
País de afiliación:
Chile