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Título:
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Time to HAART initiation after diagnosis and treatment of opportunistic infections in patients with AIDS in Latin America
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Autores:
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Crabtree-Ramírez, B. ;
Caro-Vega, Y. ;
Shepherd, B.E. ;
Grinsztejn, B. ;
Wolff, M. ;
Cortes, C.P. ;
Padgett, D. ;
Carriquiry, G. ;
Fink, V. ;
Jayathilake, K. ;
Person, A.K. ;
McGowan, C. ;
Sierra-Madero, J. ;
CCASAnet
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Tipo de documento:
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texto impreso
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Editorial:
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Public Library of Science, 2019-04-24T18:23:56Z
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Nota general:
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info:eu-repo/semantics/restrictedAccess
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
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Idiomas:
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Inglés
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Palabras clave:
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Editados por otras instituciones
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Artículos
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Artículos en revistas indizadas
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Resumen:
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Background: Since 2009, earlier initiation of highly active antiretroviral therapy (HAART) after an opportunistic infection (OI) has been recommended based on lower risks of death and AIDS-related progression found in clinical trials. Delay in HAART initiation after OIs may be an important barrier for successful outcomes in patients with advanced disease. Timing of HAART initiation after an OI in "real life" settings in Latin America has not been evaluated. Methods: Patients in the Caribbean, Central and South America network for HIV Epidemiology (CCA-SAnet) ?18 years of age at enrolment, from 2001-2012 who had an OI before HAART initiation were included. Patients were divided in an early HAART (EH) group (those initiating within 4 weeks of an OI) and a delayed HAART (DH) group (those initiating more than 4 weeks after an OI). All patients with an AIDS-defining OI were included. In patients with more than one OI the first event reported was considered. Calendar trends in the proportion of patients in the EH group (before and after 2009) were estimated by site and for the whole cohort. Factors associated with EH were estimated using multivariable logistic regression models. Results: A total of 1457 patients had an OI before HAART initiation and were included in the analysis: 213 from Argentina, 686 from Brazil, 283 from Chile, 119 from Honduras and 156 from Mexico. Most prevalent OI were Tuberculosis (31%), followed by Pneumocystis pneumonia (24%), Invasive Candidiasis (16%) and Toxoplasmosis (9%). Median time from OI to HAART initiation decreased significantly from 5.7 (interquartile range [IQR] 2.8-12.1) weeks before 2009 to 4.3 (IQR 2.0-7.1) after 2009 (p
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En línea:
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http://doi.org/10.1371/journal.pone.0153921
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