Universidad Peruana Cayetano Heredia
A decade of HAART in Latin America: Long term outcomes among the first wave of HIV patients to receive combination therapy
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| dc.contributor.author | Wolff, Marcelo J. | |
| dc.contributor.author | Giganti, Mark J. | |
| dc.contributor.author | Cortes, Claudia P. | |
| dc.contributor.author | Cahn, Pedro | |
| dc.contributor.author | Grinsztejn, Beatriz | |
| dc.contributor.author | Pape, Jean W. | |
| dc.contributor.author | Padgett, Denis | |
| dc.contributor.author | Sierra-Madero, Juan | |
| dc.contributor.author | Gotuzzo Herencia, José Eduardo | |
| dc.contributor.author | Duda, Stephany N. | |
| dc.contributor.author | McGowan, Catherine C. | |
| dc.contributor.author | Shepherd, Bryan E. | |
| dc.contributor.author | CCASAnet | |
| dc.date.accessioned | 2019-01-25T15:02:13Z | |
| dc.date.available | 2019-01-25T15:02:13Z | |
| dc.date.issued | 2017 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.12866/4584 | |
| dc.description.abstract | BACKGROUND: In Latin America, the first wave of HIV-infected patients initiated highly active antiretroviral therapy (HAART) 10 or more years ago. Characterizing their treatment experience and corresponding outcomes across a decade of HAART may yield insights relevant to the ongoing care of such patients and those initiating HAART more recently in similar clinical settings. METHODS: This retrospective study included adults initiating HAART before 2004 at 8 sites in Argentina, Brazil, Chile, Haiti, Honduras, and Mexico. Patient status (in care, dead, or lost to follow-up [LTFU]) was assessed at 6-month intervals for 10 years, along with CD4 count and HIV-1 viral load (VL) for patients in care. RESULTS: 4,975 patients (66% male) started HAART prior to 2004; 45% were not antiretroviral-naïve. At 1, 5, and 10 years, rates of mortality were 4.2%, 9.0%, and 13.6% respectively. LTFU rates for the same periods were 2.4%, 10.9%, and 24.2%. Among patients remaining in care at 10 years, 84.4% were estimated to have VL≤400 copies/mL (Haiti excluded) and median baseline CD4 increased from 158 to 525 cells/mm3. Only 11.4% of all patients remained on their first regimen, 12.6% were on their second, 11.5% were on their third, and 23.0% were on their fourth or subsequent regimen. Outcomes were generally better for patients who were not antiretroviral-naïve, except for viral suppression. Heterogeneity among sites was substantial. CONCLUSIONS: Despite advanced disease and predominant use of older antiretrovirals, a large percentage of early HAART initiators in this Latin American cohort were alive and in care with sustained virologic suppression and progressive immune recovery after 10 years. | 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 | Antiretroviral Therapy, Highly Active/trends | en_US |
| dc.subject | Adult | en_US |
| dc.subject | CD4 Lymphocyte Count | en_US |
| dc.subject | Cohort Studies | en_US |
| dc.subject | Female | en_US |
| dc.subject | HIV Infections/drug therapy/immunology/mortality | en_US |
| dc.subject | Humans | en_US |
| dc.subject | Latin America/epidemiology | en_US |
| dc.subject | Male | en_US |
| dc.subject | Retrospective Studies | en_US |
| dc.subject | Time Factors | en_US |
| dc.subject | Treatment Outcome | en_US |
| dc.subject | Viral Load | en_US |
| dc.title | A decade of HAART in Latin America: Long term outcomes among the first wave of HIV patients to receive combination therapy | en_US |
| dc.type | info:eu-repo/semantics/article | |
| dc.identifier.doi | https://doi.org/10.1371/journal.pone.0179769 | |
| dc.subject.ocde | https://purl.org/pe-repo/ocde/ford#3.03.02 | |
| dc.subject.ocde | https://purl.org/pe-repo/ocde/ford#3.03.08 | |
| dc.subject.ocde | https://purl.org/pe-repo/ocde/ford#3.01.05 | |
| dc.relation.issn | 1932-6203 |
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