Universidad Peruana Cayetano Heredia

Cross-sectional analysis of late HARRT initiation in Latin America and the Caribbean: Late testers and late presenters

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dc.contributor.author Crabtree-Ramírez, B.
dc.contributor.author Caro-Vega, Y.
dc.contributor.author Shepherd, B.E.
dc.contributor.author Wehbe, F.
dc.contributor.author Cesar, C.
dc.contributor.author Cortés, C.
dc.contributor.author Padgett, D.
dc.contributor.author Koenig, S.
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Cahn, P.
dc.contributor.author McGowan, C.
dc.contributor.author Masys, D.
dc.contributor.author Sierra-Madero, J.
dc.contributor.author The CCASAnet Team
dc.date.accessioned 2022-01-18T19:34:38Z
dc.date.available 2022-01-18T19:34:38Z
dc.date.issued 2011
dc.identifier.uri https://hdl.handle.net/20.500.12866/11090
dc.description.abstract Background: Starting HAART in a very advanced stage of disease is assumed to be the most prevalent form of initiation in HIV-infected subjects in developing countries. Data from Latin America and the Caribbean is still lacking. Our main objective was to determine the frequency, risk factors and trends in time for being late HAART initiator (LHI) in this region. Methodology: Cross-sectional analysis from 9817 HIV-infected treatment-naïve patients initiating HAART at 6 sites (Argentina, Chile, Haiti, Honduras, Peru and Mexico) from October 1999 to July . LHI had CD4+ count ≤200cells/mm3 prior to HAART. Late testers (LT) were those LHI who initiated HAART within 6 months of HIV diagnosis. Late presenters (LP) initiated after 6 months of diagnosis. Prevalence, risk factors and trends over time were analyzed. Principal Findings: Among subjects starting HAART (n = 9817) who had baseline CD4+ available (n = 8515), 76% were LHI: Argentina (56%[95%CI:52-59]), Chile (80%[95%CI:77-82]), Haiti (76%[95%CI:74-77]), Honduras (91%[95%CI:87-94]), Mexico (79%[95%CI:75-83]), Peru (86%[95%CI:84-88]). The proportion of LHI statistically changed over time (except in Honduras) (p≤0.02; Honduras p = 0.7), with a tendency towards lower rates in recent years. Males had increased risk of LHI in Chile, Haiti, Peru, and in the combined site analyses (CSA). Older patients were more likely LHI in Argentina and Peru (OR 1.21 per +10-year of age, 95%CI:1.02-1.45; OR 1.20, 95%CI:1.02-1.43; respectively), but not in CSA (OR 1.07, 95%CI:0.94-1.21). Higher education was associated with decreased risk for LHI in Chile (OR 0.92 per +1-year of education, 95%CI:0.87-0.98) (similar trends in Mexico, Peru, and CSA). LHI with date of HIV-diagnosis available, 55% were LT and 45% LP. Conclusion: LHI was highly prevalent in CCASAnet sites, mostly due to LT; the main risk factors associated were being male and older age. Earlier HIV-diagnosis and earlier treatment initiation are needed to maximize benefits from HAART in the region. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Peru en_US
dc.subject Risk Factors en_US
dc.subject controlled study en_US
dc.subject Cross-Sectional Studies en_US
dc.subject major clinical study en_US
dc.subject Central America en_US
dc.subject sex difference en_US
dc.subject Latin America en_US
dc.subject South and Central America en_US
dc.subject prevalence en_US
dc.subject Human immunodeficiency virus infection en_US
dc.subject methodology en_US
dc.subject Multivariate Analysis en_US
dc.subject Time Factors en_US
dc.subject CD4 lymphocyte count en_US
dc.subject education en_US
dc.subject Antiretroviral Therapy, Highly Active en_US
dc.subject Chile en_US
dc.subject Mexico en_US
dc.subject Argentina en_US
dc.subject antiretrovirus agent en_US
dc.subject Honduras en_US
dc.subject therapy delay en_US
dc.subject Haiti en_US
dc.subject Caribbean Region en_US
dc.title Cross-sectional analysis of late HARRT initiation in Latin America and the Caribbean: Late testers and late presenters en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0020272
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1932-6203


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