Universidad Peruana Cayetano Heredia

Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America

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dc.contributor.author Cesar, C.
dc.contributor.author Koethe, J.R.
dc.contributor.author Giganti, M.J.
dc.contributor.author Rebeiro, P.
dc.contributor.author Althoff, K.N.
dc.contributor.author Napravnik, S.
dc.contributor.author Mayor, A.
dc.contributor.author Grinsztejn, B.
dc.contributor.author Wolff, M.
dc.contributor.author Padgett, D.
dc.contributor.author Sierra Madero, J.
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Sterling, T.R.
dc.contributor.author Willig, J.
dc.contributor.author Levison, J.
dc.contributor.author Kitahata, M.
dc.contributor.author Rodriguez-Barradas, M.C.
dc.contributor.author Moore, R.D.
dc.contributor.author McGowan, C.
dc.contributor.author Shepherd, B.E.
dc.contributor.author Cahn, P.
dc.date.accessioned 2019-04-24T18:23:55Z
dc.date.available 2019-04-24T18:23:55Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/6481
dc.description.abstract Introduction: Latinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America. Methods: HIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts. Results: The study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/μL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI):1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57). Conclusions: HIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Journal of the International AIDS Society
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject abacavir en_US
dc.subject anti human immunodeficiency virus agent en_US
dc.subject atazanavir en_US
dc.subject efavirenz en_US
dc.subject emtricitabine en_US
dc.subject lamivudine en_US
dc.subject lopinavir en_US
dc.subject nelfinavir en_US
dc.subject nevirapine en_US
dc.subject stavudine en_US
dc.subject tenofovir en_US
dc.subject zidovudine en_US
dc.subject anti human immunodeficiency virus agent en_US
dc.subject adult en_US
dc.subject Article en_US
dc.subject Canada en_US
dc.subject CD4 lymphocyte count en_US
dc.subject confidence interval en_US
dc.subject controlled study en_US
dc.subject female en_US
dc.subject follow up en_US
dc.subject highly active antiretroviral therapy en_US
dc.subject Hispanic en_US
dc.subject human en_US
dc.subject Human immunodeficiency virus infection en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject men who have sex with men en_US
dc.subject middle aged en_US
dc.subject mortality en_US
dc.subject North America en_US
dc.subject outcome assessment en_US
dc.subject priority journal en_US
dc.subject proportional hazards model en_US
dc.subject South and Central America en_US
dc.subject United States en_US
dc.subject comparative study en_US
dc.subject HIV Infections en_US
dc.subject South America en_US
dc.subject treatment outcome en_US
dc.subject Adult en_US
dc.subject Anti-HIV Agents en_US
dc.subject Canada en_US
dc.subject Female en_US
dc.subject Hispanic Americans en_US
dc.subject HIV Infections en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject North America en_US
dc.subject Proportional Hazards Models en_US
dc.subject South America en_US
dc.subject Treatment Outcome en_US
dc.subject United States en_US
dc.title Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.7448/IAS.19.1.20684
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1758-2652


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