Factors associated with mortality in HIV patients failing antiretroviral therapy, in Salvador, Brazil

Haguihara, Tatiana; Silva, Márcio da Oliveira; Rebouças, Monaliza Cardozo; Netto, Eduardo Martins; Brites, Carlos

doi:10.1016/j.bjid.2019.06.001

Cited by 9 publications

(10 citation statements)

References 6 publications

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“…A number of studies have reported higher [14], lower [15], and similar [17] proportions of deaths compared with our study. Several studies have reported that older age [17,18], male gender [15,17], low baseline count of CD4 T cell [14][15][16][17][19][20][21][22][23], advanced clinical stage [17], high viral load [21,22,24], and TB co-infection [17] are associated with a higher risk of death. However, our study revealed that sex and sexual behavior were not associated with ART outcome.…”

Section: Survival/mortality and Baseline Characteristicsmentioning

confidence: 99%

“…Several research works was dedicated to molecular epidemiological and virological aspects of HIV infection in the country [12,13] but there are no research reports addressed to immune disorder state and immunomonitoring during ART in Mongolian patients with HIV/AIDS. Great number of studies in different countries and regions were focused on association of HIV/AIDS patients' baseline characteristics before initiation of ART with survival [14][15][16][17][18][19][20][21][22], immune recovery [18,[22][23][24] and immune reconstitution during the therapy. But reports analyzed association of ART outcome with pretreatment characteristics of HIV/AIDS patients in Mongolia still did not appeared.…”

Section: Introductionmentioning

confidence: 99%

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Survival, CD4 T lymphocyte count recovery and immune reconstitution pattern during the first-line combination antiretroviral therapy in patients with HIV-1 infection in Mongolia

et al. 2021

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Mongolia has a low incidence of human immunodeficiency virus (HIV) infection, with 281 cases reported at the end of 2019 and an estimated incidence rate of <0.01 cases per 1000 population. However, no study has analyzed the association between antiretroviral therapy (ART) outcomes and pretreatment characteristics of patients with HIV/acquired immunodeficiency syndrome (AIDS) in Mongolia. This retrospective study aimed to determine the survival, CD4 T cell recovery, and immune reconstitution pattern during ART in HIV patients and to determine baseline patient characteristics associated with ART outcomes. Based on three different World Health Organization (WHO) guidelines, we analyzed the 3-year observation data of 166 patients with HIV/AIDS who received treatment between 2010 and 2017. An increase of >50 cells/μL indicated CD4 T cell count recovery, and a cell count of ≥500 cells/μL in patients with a baseline cell count of <500 cells/μL indicated immune reconstitution. In this study, the 3- and 1-year mortality rates were 5.4% (survival rate: 94.6%) and 3.6%, respectively. A total of 83% of deaths that occurred in the observation time occurred within the first 3 months. The CD4 T cell count recovery rates at 3, 12, and 36 months were 62.7%, 80.7%, and 89.2%, respectively. The CD4 T cell count increased to >500 cells/μL in 95 of 145 (65.5%) patients with a baseline cell count of <500 cells/μL after 36 months of ART. The baseline CD4 T cell count was found to be a sensitive indicator for immune reconstitution. An advanced pretreatment clinical stage of HIV infection (as classified by the WHO classification), a low CD4 T cell count in the peripheral blood, and a high viral load before the initiation of the first-line ART accurately predicted survival, CD4 T cell count recovery, and immune reconstitution in Mongolian patients with HIV/AIDS.

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Section: Survival/mortality and Baseline Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival, CD4 T lymphocyte count recovery and immune reconstitution pattern during the first-line combination antiretroviral therapy in patients with HIV-1 infection in Mongolia

et al. 2021

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“…Adherence to ART also reduces rates of mother-to-child transmission (MTCT) of HIV (8)(9)(10)(11). Suboptimal adherence to ART is detrimental: it is associated with virologic failure (12)(13)(14)(15)(16)(17)(18)(19), drug resistance (12,(20)(21)(22)(23), and ultimately death (24)(25)(26)(27)(28)(29)(30). In 2014, the United Nations Program on HIV/AIDS (UNAIDS) launched the 90-90-90 global targets for HIV and AIDS programming.…”

Section: Introductionmentioning

confidence: 99%

Hunger and Adherence to Antiretroviral Therapy: Learning From HIV Positive Caregivers of Orphans and Vulnerable Children in Tanzania

Exavery¹,

Charles²,

Kuhlik

et al. 2022

Front. Public Health

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The association between hunger and adherence to antiretroviral therapy (ART) is less known especially in vulnerable populations receiving HIV care and treatment services. Caregivers of orphans and vulnerable children (OVC) are vulnerable and likely to experience hunger due to additional economic pressure in caring for OVC. Using data from the community–based, USAID–funded Kizazi Kipya project, this study assesses the association between hunger and ART adherence among caregivers of OVC in Tanzania. HIV positive caregivers enrolled in the project from January to July 2017 were analyzed. The outcome variable was adherence to ART, defined as “not having missed any ART dose in the last 30 days,” and household hunger, measured using the Household Hunger Scale (HHS), was the main independent variable. Data analysis included multivariable logistic regression. The study analyzed 11,713 HIV positive caregivers who were on ART at the time of enrollment in the USAID Kizazi Kipya project in 2017. Aged 48.2 years on average, 72.9% of the caregivers were female. While 34.6% were in households with little to no hunger, 59.4 and 6.0% were in moderate hunger and severe hunger households, respectively. Overall, 90.0% of the caregivers did not miss any ART dose in the last 30 days. ART adherence rates declined as household hunger increased (p < 0.001). Multivariable analysis showed that the odds of adhering to ART was significantly lower by 42% among caregivers in moderate hunger households than those in little to no hunger households (OR = 0.58, 95% CI 0.50–0.68). The decline increased to 47% among those in severe hunger households (OR = 0.53, 95% CI 0.41–0.69). Hunger is an independent and a significant barrier to ART adherence among caregivers LHIV in Tanzania. Improving access to adequate food as part of HIV care and treatment services is likely to improve ART adherence in this population.

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“…Outros achados nacionais também revelam semelhança com o perfil de mortalidade da população encontrada. O sexo masculino, exposição heterossexual e menor escolaridade, foram frequentemente descritos como uma população com maior propensão a hospitalização e óbito por Aids (HAGUIHARA et al, 2019;MELO et al, 2019;GONÇALES et al, 2021).…”

Section: Discussionunclassified

“…Baixo nível de educação e falta de tratamento para a dependência também são fatores que aumentam o risco do UDI ao HIV (HOGAN et al, 2021). Ainda, em uma coorte realizada com PVHIV com objetivo de avaliar aqueles que não fazem adesão à terapia antirretroviral altamente ativa, os UDI apresentaram maior propensão a falha virológica e morte pelo agravo (HAGUIHARA et al, 2019).…”

Section: Discussionunclassified

Fatores demográficos e clínicos associados ao óbito por AIDS em uma região no Sul do Brasil / Demographic and clinical factors associated with AIDS death in a Brazil Southern region

Montanha¹,

Kerbauy²,

Arcêncio³

et al. 2022

BJDV

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O objetivo do estudo foi analisar os fatores demográficas e clínicos associados ao óbito por Aids. Este foi um estudo transversal, analítico, realizado com dados obtidos do Sistema de Informação de Agravo e Notificação HIV/Aids pertencentes a Macro Região Norte do Estado do Paraná, notificados no período de 2007 a 2019. Modelo de regressão de Poisson com variância robusta foi utilizado para estimar a razão de prevalência e seus respectivos intervalos de confiança de 95% (IC 95%), adotando um nível de significância de 0,05. Dos 5.591 casos notificados, 14,7% evoluíram a óbito por Aids no período. Na análise multivariada, o óbito foi associado ao sexo masculino (RP=1,38; IC95% 1,17-1,63), indivíduos sem escolaridade e até 8 anos de estudo (RP= 2,54; IC95% 1,81-3,57 e RP= 1,81; IC95% 1,51-2,16), heterossexuais (RP= 1,58; IC95% 1,28-1,94) e usuários de drogas injetáveis (RP= 1,67; IC95% 1,27-2,19). Contagem de linfócitos T CD4+ menor que 350 cel/mm³ foi o sinal clínico com maior prevalência de notificações e esteve associado ao óbito (1,43 (1,23-1,66). Criptococose extrapulmonar (RP= 3,90; IC95% 3,06-4,96), toxoplasmose cerebral (RP= 3,27; IC95% 2,72-3,92) e disfunção do Sistema Nervoso Central (RP= 2,84; IC95% 2,42-3,33) foram infecções oportunistas fortemente associadas ao óbito por Aids. Conclui-se que a mortalidade por Aids esteve associada aos homens, menor escolaridade, heterossexuais, uso de drogas injetáveis, apresentação de sinais clínicos e infecções oportunistas. Diagnóstico e tratamento oportuno e rastreio de infecções oportunistas devem ser priorizados a fim de reduzir a mortalidade dessa população.

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Factors associated with mortality in HIV patients failing antiretroviral therapy, in Salvador, Brazil

Cited by 9 publications

References 6 publications

Survival, CD4 T lymphocyte count recovery and immune reconstitution pattern during the first-line combination antiretroviral therapy in patients with HIV-1 infection in Mongolia

Survival, CD4 T lymphocyte count recovery and immune reconstitution pattern during the first-line combination antiretroviral therapy in patients with HIV-1 infection in Mongolia

Hunger and Adherence to Antiretroviral Therapy: Learning From HIV Positive Caregivers of Orphans and Vulnerable Children in Tanzania

Fatores demográficos e clínicos associados ao óbito por AIDS em uma região no Sul do Brasil / Demographic and clinical factors associated with AIDS death in a Brazil Southern region

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