Survival of AIDS patients and characteristics of those who died over eight years of highly active antiretroviral therapy, at a referral center in northeast Brazil

Abstract

Introduction of highly active antiretroviral therapy has resulted in a significant reduction in morbimortality and significant changes in the causes of death among HIV/AIDS patients. For this reason, it has become essential to monitor survival and causes of death. We constructed a survival curve based on 597 adult patients notified as AIDS cases between 1997 and 2004, at the Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil. Among those patients, 150 (25%) progressed to death by December, 2005. Of these, 119 were studied in detail. The data were collected from notification files of the State Health Department and the State Mortality Information System, and were complemented by analysis of medical records. These 597 patients had a survival rate of 88%, 86% and 82% after one, two and five years, respectively, and a 75% likelihood of surviving to 1,984 days (66 months). Most of the deaths occurred during the first months after the diagnosis (median, 129 days). Patients who died were predominantly young men who had sexual exposure and came from Recife (the state capital) or its metropolitan region. When the patients were first seen, a large proportion had already presented severe signs of immunodeficiency. Comparing the patients within this group, the characteristics that were associated with lower survival were: male sex, hemoglobin < 10 mg/dL, lymphocytes < 1,000/mm(3), use of fewer therapeutic drugs and antiretroviral regimens and non-introduction of protease inhibitors. Most of them died from AIDS-related diseases, particularly undefined respiratory infections.

Sobrevida de pacientes com Síndrome da Imunodeficiência Adquirida em hospital geral no Rio de Janeiro, a partir de dados da vigilância epidemiológica

“…Assim, o ano da introdução do esquema HAART (1996) parece ser um marco significativo, e tem sido utilizado como divisor de águas para esse aumento de sobrevida 8 , e a consequente mudança na evolução da epidemia 9 . Tendo em vista a necessidade de controle das doenças transmissíveis, dados de vigilância epidemiológica (VE) têm-se constituído em uma fonte de informações importante para avaliação do curso de epidemias e endemias.…”

Recent HIV infection rates among HIV positive patients seeking voluntary counseling and testing centers in the metropolitan region of Recife - Pe, Brazil

“…generally at a late stage and with advanced immunosuppression. 18,19 Failures of post-test counseling to convey the benefits of early medical follow-up, or difficulties in accessing medical care are important factors in the previously described disparity between the time of diagnosis at the VCT and the presentation for medical care in Brazil. 11 There was no great variation in viral subtypes found between recent and chronic infections, with predominance of subtype B followed by subtype F. Differing from the southern region of the country, the frequency of subtype C remained low in both groups (less than 5%).…”

Demographic determinants of survival of people living with HIV attending an outpatient reference unit in the city of Três Lagoas, state of Mato Grosso do Sul, Brazil, in the period 1984-2009

“…That association has been described in previous reports, even though authors have found contradictory results. Lower mortality for women was reported in studies conducted in Brazil 9 and in African and Asian countries 13 . In contrast, women were found to have shorter survival in the follow-up of a cohort from Rio de Janeiro, Brazil 7 .…”

“…This is the case of survival analysis, which has been performed on whole-country health surveillance databases 5,6 or with follow-up of cohorts from large cities [7][8][9][10] . These studies report longer survival times for men that have sex with men (MSM) and patients admitted without AIDS-defining conditions.…”