BACKGROUND: The impact of HAART (highly active antiretroviral therapy) on the time for progression from HIV diagnosis to AIDS (TPHA) has been little studied in middle-income countries. This study aimed to analyze the TPHA in the pre- and post-HAART eras and to investigate its predictors. METHOD: We carried out a retrospective cohort study, including 1879 AIDS-free HIV-infected individuals diagnosed between 1988 and 2003 and followed up until 2005. The incidences of AIDS were estimated in person-years. The Kaplan-Meier method was applied to estimate TPHA and the Cox proportional hazard model used to assess predictors of TPHA. RESULTS: AIDS incidence decreased from 12.8 to 5.0 per 1000 person-years over the period 1992 to 2003. TPHA (cumulative probability of AIDS-free time) for the maximum follow-up of 9 years was 21.9% among untreated individuals and 76.8% among those on HAART. Predictors of shorter TPHA included non-HAARTART treatment; no treatment; age ≥50 years; black/brown skin color; injection drug use; no schooling; and baseline CD4 lower than 500 cells/mm3. CONCLUSION: HAART has decreased AIDS incidence, prolonged life and increased the number of people living with HIV/AIDS. The post-HAART era presents new challenges to healthcare services in middle-income countries, the main requirements being enhanced strategies focused on early diagnosis, more resource allocation and developing approaches for healthcare systems to manage AIDS as a chronic disease.
BACKGROUND: The impact of HAART (highly active antiretroviral therapy) on the time for progression from HIV diagnosis to AIDS (TPHA) has been little studied in middle-income countries. This study aimed to analyze the TPHA in the pre- and post-HAART eras and to investigate its predictors. METHOD: We carried out a retrospective cohort study, including 1879 AIDS-free HIV-infected individuals diagnosed between 1988 and 2003 and followed up until 2005. The incidences of AIDS were estimated in person-years. The Kaplan-Meier method was applied to estimate TPHA and the Cox proportional hazard model used to assess predictors of TPHA. RESULTS:AIDS incidence decreased from 12.8 to 5.0 per 1000 person-years over the period 1992 to 2003. TPHA (cumulative probability of AIDS-free time) for the maximum follow-up of 9 years was 21.9% among untreated individuals and 76.8% among those on HAART. Predictors of shorter TPHA included non-HAARTART treatment; no treatment; age ≥50 years; black/brown skin color; injection drug use; no schooling; and baseline CD4 lower than 500 cells/mm3. CONCLUSION: HAART has decreased AIDS incidence, prolonged life and increased the number of people living with HIV/AIDS. The post-HAART era presents new challenges to healthcare services in middle-income countries, the main requirements being enhanced strategies focused on early diagnosis, more resource allocation and developing approaches for healthcare systems to manage AIDS as a chronic disease.
Authors: Hanalise V Huff; Paloma M Carcamo; Monica M Diaz; Jamie L Conklin; Justina Salvatierra; Rocio Aponte; Patricia J Garcia Journal: Int J Environ Res Public Health Date: 2022-06-12 Impact factor: 4.614
Authors: Daniel S Teixeira da Silva; Paula M Luz; Jordan E Lake; Sandra W Cardoso; Sayonara Ribeiro; Ronaldo I Moreira; Jesse L Clark; Valdilea G Veloso; Beatriz Grinsztejn; Raquel B De Boni Journal: AIDS Care Date: 2016-07-27
Authors: Lyolya Hovhannisyan; Lara E Coelho; Luciane Velasque; Raquel B De Boni; Jesse Clark; Sandra W Cardoso; Jordan Lake; Valdilea G Veloso; Beatriz Grinsztejn; Paula M Luz Journal: AIDS Behav Date: 2021-09-25
Authors: Lin Chen; Jiezhe Yang; Renjie Zhang; Yun Xu; Jinlei Zheng; Jianmin Jiang; Jun Jiang; Lin He; Ning Wang; Philip Chun Yeung; Xiaohong Pan Journal: AIDS Res Ther Date: 2015-09-25 Impact factor: 2.250