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Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study

Angriman, Federico, Belloso, Waldo H., Sierra-Madero, Juan, Sánchez, Jorge, Moreira, Ronaldo Ismerio, Kovalevski, Leandro O., Orellana, Liliana C., Wagner Cardoso, Sanra, Crabtree-Ramirez, Brenda, La Rosa, Alberto and Losso, Marcelo H. 2016, Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study, International journal of STD & AIDS, vol. 27, no. 2, pp. 118-126, doi: 10.1177/0956462415575621.

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Title Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study
Author(s) Angriman, Federico
Belloso, Waldo H.
Sierra-Madero, Juan
Sánchez, Jorge
Moreira, Ronaldo Ismerio
Kovalevski, Leandro O.
Orellana, Liliana C.ORCID iD for Orellana, Liliana C. orcid.org/0000-0003-3736-4337
Wagner Cardoso, Sanra
Crabtree-Ramirez, Brenda
La Rosa, Alberto
Losso, Marcelo H.
Journal name International journal of STD & AIDS
Volume number 27
Issue number 2
Start page 118
End page 126
Total pages 9
Publisher SAGE Publications
Place of publication London, Eng.
Publication date 2016-02
ISSN 0956-4624
1758-1052
Keyword(s) HIV
AIDS
treatment
outcomes
CD4 cell lymphocyte count
cohort studies
Latin America
antiretroviral therapy
Summary Nearly 2 million people are infected with human immunodeficiency virus (HIV) in Latin America. However, information regarding population-scale outcomes from a regional perspective is scarce. We aimed to describe the baseline characteristics and therapeutic outcomes of newly-treated individuals with HIV infection in Latin America. A Retrospective cohort study was undertaken. The primary explanatory variable was combination antiretroviral therapy based on either a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI). The main outcome was defined as the composite of all-cause mortality and the occurrence of an AIDS-defining clinical event or a serious non-AIDS-defining event during the first year of therapy. The secondary outcomes included the time to a change in treatment strategy. All analyses were performed according to the intention to treat principle. A total of 937 treatment-naive patients from four participating countries were included (228 patients with PI therapy and 709 with NNRTI-based treatment). At the time of treatment initiation, the patients had a mean age of 37 (SD: 10) years and a median CD4 + T-cell count of 133 cells/mm(3) (interquartile range: 47.5-216.0). Patients receiving PI-based regimens had a significantly lower CD4 + count, a higher AIDS prevalence at baseline and a shorter time from HIV diagnosis until the initiation of treatment. There was no difference in the hazard ratio for the primary outcome between groups. The only covariates associated with the latter were CD4 + cell count at baseline, study site and age. The estimated hazard ratio for the time to a change in treatment (NNRTI vs PI) was 0.61 (95% CI 0.47-0.80, p < 0.01). This study concluded that patients living with HIV in Latin America present with similar clinical outcomes regardless of the choice of initial therapy. Patients treated with PIs are more likely to require a treatment change during the first year of follow up.
Language eng
DOI 10.1177/0956462415575621
Field of Research 111799 Public Health and Health Services not elsewhere classified
1103 Clinical Sciences
1108 Medical Microbiology
1117 Public Health And Health Services
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30084378

Document type: Journal Article
Collection: Faculty of Health
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