OBJECTIVE: To report emerging data on the use of highly active antiretroviral therapy (HAART) in Argentina by assessing patterns of HAART access and late vs early treatment initiation in a population-based cohort of adults infected with HIV type-1. DESIGN: The Prospective Study on the Use and Monitoring of Antiretroviral Therapy (PUMA) is a study of 883 HIV-positive individuals enrolled in the Argentinean drug treatment program. Individuals were 16 years of age and older and were recruited from 10 clinics across Argentina. METHODS: Sociodemographic and clinical characteristics were examined using contingency tables (Pearson chi-square test and Fisher exact test) for categoric variables and Wilcoxon rank-sum test for continuous variables. To analyze time to initiation of HAART we used Kaplan-Meier methods and Cox regression. RESULTS: Patients who initiated HAART were more likely to be older, have an AIDS-defining illness, be an injection drug user (IDU), have a lower median CD4 cell count, have a higher median viral load, and be less likely to be men who have sex with men (MSM). In multivariate analysis, AIDS-defining illness and plasma viral load were significantly associated with time to starting therapy. Patients who received late access were more likely to be diagnosed with AIDS and have higher median plasma viral loads than those receiving early access. CONCLUSION: Our results indicate that despite free availability of treatment, monitoring, and care in Argentina, a significant proportion of men and women are accessing HAART late in the course of HIV disease. Further characterization of the HIV-positive population will allow for a more comprehensive evaluation of the impact of HAART within the Argentinean drug treatment program.
OBJECTIVE: To report emerging data on the use of highly active antiretroviral therapy (HAART) in Argentina by assessing patterns of HAART access and late vs early treatment initiation in a population-based cohort of adults infected with HIV type-1. DESIGN: The Prospective Study on the Use and Monitoring of Antiretroviral Therapy (PUMA) is a study of 883 HIV-positive individuals enrolled in the Argentinean drug treatment program. Individuals were 16 years of age and older and were recruited from 10 clinics across Argentina. METHODS: Sociodemographic and clinical characteristics were examined using contingency tables (Pearson chi-square test and Fisher exact test) for categoric variables and Wilcoxon rank-sum test for continuous variables. To analyze time to initiation of HAART we used Kaplan-Meier methods and Cox regression. RESULTS:Patients who initiated HAART were more likely to be older, have an AIDS-defining illness, be an injection drug user (IDU), have a lower median CD4 cell count, have a higher median viral load, and be less likely to be men who have sex with men (MSM). In multivariate analysis, AIDS-defining illness and plasma viral load were significantly associated with time to starting therapy. Patients who received late access were more likely to be diagnosed with AIDS and have higher median plasma viral loads than those receiving early access. CONCLUSION: Our results indicate that despite free availability of treatment, monitoring, and care in Argentina, a significant proportion of men and women are accessing HAART late in the course of HIV disease. Further characterization of the HIV-positive population will allow for a more comprehensive evaluation of the impact of HAART within the Argentinean drug treatment program.
Authors: Scott M Hammer; Michael S Saag; Mauro Schechter; Julio S G Montaner; Robert T Schooley; Donna M Jacobsen; Melanie A Thompson; Charles C J Carpenter; Margaret A Fischl; Brian G Gazzard; Jose M Gatell; Martin S Hirsch; David A Katzenstein; Douglas D Richman; Stefano Vella; Patrick G Yeni; Paul A Volberding Journal: Top HIV Med Date: 2006 Aug-Sep
Authors: S G Wannamethee; S Sirivichayakul; A N Phillips; S Ubolyam; K Ruxrungtham; M Hanvanich; P Phanuphak Journal: Int J Epidemiol Date: 1998-04 Impact factor: 7.196
Authors: S M Hammer; K E Squires; M D Hughes; J M Grimes; L M Demeter; J S Currier; J J Eron; J E Feinberg; H H Balfour; L R Deyton; J A Chodakewitz; M A Fischl Journal: N Engl J Med Date: 1997-09-11 Impact factor: 91.245
Authors: Paula Braitstein; Martin W G Brinkhof; François Dabis; Mauro Schechter; Andrew Boulle; Paolo Miotti; Robin Wood; Christian Laurent; Eduardo Sprinz; Catherine Seyler; David R Bangsberg; Eric Balestre; Jonathan A C Sterne; Margaret May; Matthias Egger Journal: Lancet Date: 2006-03-11 Impact factor: 79.321
Authors: Dario A Dilernia; Daniela C Monaco; Carina Cesar; Alejandro J Krolewiecki; Samuel R Friedman; Pedro Cahn; Horacio Salomon Journal: PLoS One Date: 2013-01-07 Impact factor: 3.240