Outcomes of HAART in HIV-1 infected individuals in Buenos Aires, Argentina.

ZALA C; HOGG R; SALOMON H; CHAN K; CERIOTTO M; BELTRAN M; BURGOS M; MONTANER JS; CAHN P

Toronto, Canadá

Congreso; XVI International AIDS Conference – Time to Deliver.; 2006

International AIDS Society

Background: Despite free access to ARVs, limited data on outcomes of HIV-infected individuals who initiate HAART are available from Argentina.Despite free access to ARVs, limited data on outcomes of HIV-infected individuals who initiate HAART are available from Argentina. Objectives: To evaluate plasma HIV-1 RNA (pVL), and CD4 among ARV-naïve HIV-positive subjects seeking for HAART.To evaluate plasma HIV-1 RNA (pVL), and CD4 among ARV-naïve HIV-positive subjects seeking for HAART. Methods: An ongoing multi-site based cohort at public HIV clinics. Between Jan 2003 and Dec 2005, consecutive HIV-1 infected individuals were prospectively followed. Primary endpoints were CD4 and pVL response. Two separate Cox-proportional hazard regression models were constructed to fit simultaneous effect on prognostic variables on the outcomes of CD4 and pVL response.An ongoing multi-site based cohort at public HIV clinics. Between Jan 2003 and Dec 2005, consecutive HIV-1 infected individuals were prospectively followed. Primary endpoints were CD4 and pVL response. Two separate Cox-proportional hazard regression models were constructed to fit simultaneous effect on prognostic variables on the outcomes of CD4 and pVL response. Results: A total of 605 participants (170 females) entered the program, of whom, 299 (49 %) initiated HAART. Median f/u was 17.8 months (IQR: 6-6-26.4). Baseline CD4 and pVL was 223 cells/mm3 (IQR: 75-431) and 48,116 copies/mL (5,523-200,153) respectively. 184 (62 %) initiated with NNRTIs and 105 (35%) initiated with PIs. A total of 85 (14 %) subjects were lost to followup. Those who started therapy were more likely to be older, to have AIDS (35 % vs. 12 %; p< 0.001) and lower CD4 (median 105 vs. 337; p< 0.001) Of the 205 participants with ³ 2 pVL measurements, 172 (84%) and 78 (38%) achieved at least one < 500 and < 50 copies/mL respectively. Participants with higher pVL at BSL and not taking NNRTI were less likely to reach 2 consecutive pVL < 50 copies/mL. Of the 272 participants with ³ 2 CD4 measurements, 49 % achieved an increase of ³100 cells over BSL. Ten (2%) patients died during the observational period.A total of 605 participants (170 females) entered the program, of whom, 299 (49 %) initiated HAART. Median f/u was 17.8 months (IQR: 6-6-26.4). Baseline CD4 and pVL was 223 cells/mm3 (IQR: 75-431) and 48,116 copies/mL (5,523-200,153) respectively. 184 (62 %) initiated with NNRTIs and 105 (35%) initiated with PIs. A total of 85 (14 %) subjects were lost to followup. Those who started therapy were more likely to be older, to have AIDS (35 % vs. 12 %; p< 0.001) and lower CD4 (median 105 vs. 337; p< 0.001) Of the 205 participants with ³ 2 pVL measurements, 172 (84%) and 78 (38%) achieved at least one < 500 and < 50 copies/mL respectively. Participants with higher pVL at BSL and not taking NNRTI were less likely to reach 2 consecutive pVL < 50 copies/mL. Of the 272 participants with ³ 2 CD4 measurements, 49 % achieved an increase of ³100 cells over BSL. Ten (2%) patients died during the observational period. Conclusions: We report data on the effect of HAART within a population-based cohort in Argentina. Initiation of HAART was associated with an advanced HIV disease. Urgent efforts are needed to optimize timing of initiation of antiretroviral therapy in our setting.We report data on the effect of HAART within a population-based cohort in Argentina. Initiation of HAART was associated with an advanced HIV disease. Urgent efforts are needed to optimize timing of initiation of antiretroviral therapy in our setting.