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Determinants of survival of people living with HIV/AIDS on antiretroviral therapy in Brazil 2006-2015.
Mangal, Tara D; Meireles, Mariana Veloso; Pascom, Ana Roberta Pati; de Almeida Coelho, Ronaldo; Benzaken, Adele Schwartz; Hallett, Timothy B.
Afiliação
  • Mangal TD; Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK. t.mangal@imperial.ac.uk.
  • Meireles MV; Ministry of Health, Department of STI, HIV/AIDS and Viral Hepatitis, SRTVN Quadra 701, Lote D, Edifício PO700 CEP, Brasília, Distrito Federal, 70719-040, Brazil. mariana.meireles@aids.gov.br.
  • Pascom ARP; Ministry of Health, Department of STI, HIV/AIDS and Viral Hepatitis, SRTVN Quadra 701, Lote D, Edifício PO700 CEP, Brasília, Distrito Federal, 70719-040, Brazil.
  • de Almeida Coelho R; Ministry of Health, Department of STI, HIV/AIDS and Viral Hepatitis, SRTVN Quadra 701, Lote D, Edifício PO700 CEP, Brasília, Distrito Federal, 70719-040, Brazil.
  • Benzaken AS; Ministry of Health, Department of STI, HIV/AIDS and Viral Hepatitis, SRTVN Quadra 701, Lote D, Edifício PO700 CEP, Brasília, Distrito Federal, 70719-040, Brazil.
  • Hallett TB; Medical Research Council Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK.
BMC Infect Dis ; 19(1): 206, 2019 Feb 28.
Article em En | MEDLINE | ID: mdl-30819120
BACKGROUND: We compared AIDS-related mortality rates in people living with HIV (PLHIV) starting antiretroviral therapy (ART) in Brazil during 2006-2015 and examined associated risk factors . METHODS: Data on ART use in PLHIV and AIDS mortality in Brazil was analysed with piecewise constant exponential models. Mortality rates and hazard ratios were estimated for 0-6, 6-12, 13-24, 25-36 and > 36 months of ART use and adjusted for region, age, sex, baseline CD4 cell count and calendar year of ART initiation. An additional analysis restricted to those with data on risk group was also performed. RESULTS: 269,076 individuals were included in the analysis, 165,643 (62%) males and 103,433 (38%) females, with 1,783,305 person-years of follow-up time. 21,749 AIDS deaths were reported and 8898 deaths occurred in the first year of ART. The risk of death in the first six months decreased with early ART initiation; those starting treatment early with CD4 > 500 cells per µL had a hazard ratio of 0.06 (95% CI 0.05-0.07) compared with CD4 < 200 cells per µL. Older age, male sex, intravenous drug use and starting treatment in earlier calendar years were associated with higher mortality rates. People living in the North, Northeast and South of Brazil experienced significantly higher AIDS mortality rates than those in the Southeast (HR 1.44, [95% CI 1.35-1.54], 1.10 [1.05-1.16] and 1.22 [1.17-1.28] respectively). CONCLUSIONS: Early treatment is likely to have contributed to the improved survival in PLHIV on ART, with the greatest benefits observed in women, younger age-groups and those living in the North.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2019 Tipo de documento: Article