Author | Núñez, Isaac | |
Author | Crabtree-Ramirez, Brenda | |
Author | Shepherd, Bryan E. | |
Author | Sterling, Timothy R. | |
Author | Cahn, Pedro | |
Author | Veloso, Valdiléa G. | |
Author | Cortes, Claudia P. | |
Author | Padgett, Denis | |
Author | Gotuzzo, Eduardo | |
Author | Sierra-Madero, Juan | |
Author | McGowan, Catherine C. | |
Author | Person, Anna K. | |
Author | Caro-Vega, Yanink | |
Access date | 2022-10-21T00:09:11Z | |
Available date | 2022-10-21T00:09:11Z | |
Document date | 2022 | |
Citation | NÚÑEZ, Isaac et al. Late-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors. International journal of infectious diseases, v. 122 p. 469-475, 2022. | en_US |
ISSN | 1201-9712 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/55226 | |
Language | eng | en_US |
Publisher | Elsevier | en_US |
Rights | restricted access | en_US |
Title | Late-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors | en_US |
Type | Article | en_US |
DOI | 10.1016/j.ijid.2022.06.041 | |
Abstract | Objectives: The aim of this study was to describe the incidence, clinical characteristics, and risk factors of late-onset opportunistic infections (LOI) in people who live with HIV (PWLHA) within the Caribbean, Central and South America network for HIV epidemiology.
Methods: We performed a retrospective cohort study including treatment-naive PWLHA enrolled at seven sites (Argentina, Brazil, Chile, Peru, Mexico, and two sites in Honduras). Follow-up began at 6 months after treatment started. Outcomes were LOI, loss to follow-up, and death. We used a Cox proportional hazards model and a competing risks model to evaluate risk factors.
Results: A total of 10,583 patients were included. Median follow up was at 5.4 years. LOI occurred in 895 (8.4%) patients. Median time to opportunistic infection was 2.1 years. The most common infections were tuberculosis (39%), esophageal candidiasis (10%), and Pneumocystis jirovecii (P. jirovecii) pneumonia (10%). Death occurred in 576 (5.4%) patients, and 3021 (28.5%) patients were lost to follow-up. A protease inhibitor-based regimen (hazard ratio 1.25), AIDS-defining events during the first 6 months of antiretroviral-treatment (hazard ratio 2.12), starting antiretroviral-treatment in earlier years (hazard ratio 1.52 for 2005 vs 2010), and treatment switch (hazard ratio 1.31) were associated with a higher risk of LOI.
Conclusion: LOI occurred in nearly one in 10 patients. People with risk factors could benefit from closer follow-up. | en_US |
Affilliation | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Ciudad de México, México. | en_US |
Affilliation | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Ciudad de México, México. | en_US |
Affilliation | Vanderbilt University Medical Center. Nashville, TN, USA. | en_US |
Affilliation | Vanderbilt University Medical Center. Nashville, TN, USA. | en_US |
Affilliation | Fundación Huésped. Buenos Aires, Argentina. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Universidad de Chile-Fundación Arriarán. Santiago, Chile. | en_US |
Affilliation | Hospital Escuela Universitario. Tegucigalpa, Honduras. | en_US |
Affilliation | Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical "Alexander von Humboldt". Lima, Perú. | en_US |
Affilliation | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Ciudad de México, México. | en_US |
Affilliation | Vanderbilt University Medical Center. Nashville, TN, USA. | en_US |
Affilliation | Vanderbilt University Medical Center. Nashville, TN, USA. | en_US |
Affilliation | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Ciudad de México, México. | en_US |
Subject | AIDS | en_US |
Subject | Cohort studies | en_US |
Subject | HIV | en_US |
Subject | Latin America | en_US |
Subject | Opportunistic infections | en_US |
Subject | Tuberculosis | en_US |