| Author | Luz, Paula Mendes | |
| Author | Bruyand, Mathias | |
| Author | Ribeiro, Sayonara | |
| Author | Bonnet, Fabrice | |
| Author | Moreira, Ronaldo Ismério | |
| Author | Hessamfar, Mojgan | |
| Author | Campos, Dayse Perreira | |
| Author | Greib, Carine | |
| Author | Cazanave, Charles | |
| Author | Veloso, Valdiléa G. | |
| Author | Dabis, François | |
| Author | Grinsztejn, Beatriz | |
| Author | Chêne, Geneviève | |
| Access date | 2018-10-03T19:21:11Z | |
| Available date | 2018-10-03T19:21:11Z | |
| Document date | 2014 | |
| Citation | LUZ, Paula Mendes et al. AIDS and Non-AIDS Severe Morbidity Associated with Hospitalizations among HIV-Infected Patients in Two Regions with Universal Access to Care and Antiretroviral Therapy, France and Brazil, 2000–2008: Hospital-Based Cohort Studies. BMC Infectious Diseases, v. 14, p. 1-13, May 2014. | pt_BR |
| ISSN | 1471-2334 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/29308 | |
| Description | Collaborators: Dabis F, Bonnet F, Breilh D, Dabis F, Dupon M, Chêne G, Fleury H, Malvy D, Mercié P, Pellegrin I, Morlat P, Neau D, Pellegrin JL, Thiébaut R, Bouchet S, Gaborieau V, Lacoste D, Tchamgoué S, Wittkop L, Chêne G, Dabis F, Thiébaut R, Bruyand M, Lawson-Ayayi S, Wittkop L, Morlat P, Bonnet F, Bernard N, Hessamfar M, Lacoste D, Vandenhende MA, Dupon M, Dauchy FA, Dutronc H, Mercié P, Duffau P, Schmeltz JR, Malvy D, Pistone T, Receveur MC, Neau D, Cazanave C, Ochoa A, Vareil MO, Pellegrin JL, Viallard JF, Greib C, Lazaro E, Fleury H, Lafon ME, Reigadas S, Trimoulet P, Breilh D, Molimard M, Bouchet S, Titier K, Moreau JF, Pellegrin I, Haramburu F, Miremont-Salamé G, Dupont A, Gerard Y, Caunègre L, André K, Bonnal F, Farbos S, Gemain MC, Ceccaldi J, Caubet O, Tchamgoué S, De Witte S, Courtault C, Monlun E, Gaborieau V, Lataste P, Meraud JP, Chossat I, Blaizeau MJ, Bruyand M, Conte V, Decoin M, Delaune J, Delveaux S, Diarra F, D'Ivernois C, Frosch A, Geffard S, Hanappier C, Lawson-Ayayi S, Lenaud E, Leleux O, Le Marec F, Leray J, Louis I, Palmer G, Pougetoux A, Sicard X, Touchard D, Uwamaliya-Nziyumvira B. | pt_BR |
| Description | IPEC/FIOCRUZ Cohort and the Aquitaine ANRS C03 Study Group. | |
| Sponsorship | This study was partially funded by the grant “Cooperation Franco-Bresilienne en Recherche Medicale Accord Inserm (Institut National de la Santé et de la Recherche Medicale)/FIOCRUZ 2010”. The ANRS C03 Aquitaine Cohort is supported by grants from the French Agency for AIDS and hepatitis research (ANRS) through the HIV Cohort Program (AC7) together with the Bordeaux School of Public Health (ISPED - Bordeaux University), Inserm CIC-EC7 and U897 (Bordeaux) and the COREVIH Aquitaine (Bordeaux University Hospital). BG and PML acknowledge funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). The funding bodies had no role in the design, collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. | |
| Language | eng | pt_BR |
| Rights | open access | pt_BR |
| Title | AIDS and non-AIDS severe morbidity associated with hospitalizations among HIV-infected patients in two regions with universal access to care and antiretroviral therapy, France and Brazil, 2000-2008: hospital-based cohort studies | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1186/1471-2334-14-278 | |
| Abstract | Background: In high-income settings, the spectrum of morbidity and mortality experienced by Human Immunodeficiency Virus (HIV)-infected individuals receiving combination antiretroviral therapy (cART) has switched from predominantly AIDS-related to non-AIDS-related conditions. In the context of universal access to care, we evaluated whether that shift would apply in Brazil, a middle-income country with universal access to treatment, as compared to France. Methods: Two hospital-based cohorts of HIV-infected individuals were used for this analysis: the ANRS CO3 Aquitaine Cohort in South Western France and the Evandro Chagas Research Institute (IPEC) Cohort of the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. Severe morbid events (AIDS- and non-AIDS-related) were defined as all clinical diagnoses associated with a hospitalization of ≥48 hours. Trends in the incidence rate of events and their determinants were estimated while adjusting for within-subject correlation using generalized estimating equations models with an auto-regressive correlation structure and robust standard errors. Result: Between January 2000 and December 2008, 7812 adult patients were followed for a total of 41,668 personyears (PY) of follow-up. Throughout the study period, 90% of the patients were treated with cART. The annual incidence rate of AIDS and non-AIDS events, and of deaths significantly decreased over the years, from 6.2, 21.1, and 1.9 AIDS, non-AIDS events, and deaths per 100 PY in 2000 to 4.3, 14.9, and 1.5/100 PY in 2008. The annual incidence rates of non-AIDS events surpassed that of AIDS-events during the entire study period. High CD4 cell counts were associated with a lower incidence rate of AIDS and non-AIDS events as well as with lower rates of specific non-AIDS events, such as bacterial, hepatic, viral, neurological, and cardiovascular conditions. Adjusted analysis showed that severe morbidity was associated with lower CD4 counts and higher plasma HIV RNAs but not with setting (IPEC versus Aquitaine). Conclusions: As information on severe morbidities for HIV-infected patients remain scarce, data on hospitalizations are valuable to identify priorities for case management and to improve the quality of life of patients with a chronic disease requiring life-long treatment. Immune restoration is highly effective in reducing AIDS and non-AIDS severe morbid events irrespective of the setting. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Pôle de Santé Publique. COREVIH Aquitaine. France / INSERM. ISPED. Centre Inserm U897- Epidemiologie-Biostatistique & CIC-EC7. France. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Pôle de Santé Publique. COREVIH Aquitaine. France / INSERM. ISPED. Centre Inserm U897- Epidemiologie-Biostatistique & CIC-EC7. France. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Pôle de Santé Publique. COREVIH Aquitaine. France / INSERM. ISPED. Centre Inserm U897- Epidemiologie-Biostatistique & CIC-EC7. France. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Hôpital Haut-Lévèque. Bordeaux, France. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Hôpital Pellegrin. Bordeaux, France. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Pôle de Santé Publique. COREVIH Aquitaine. France / INSERM. ISPED. Centre Inserm U897- Epidemiologie-Biostatistique & CIC-EC7. France. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Centre Hospitalier Universitaire de Bordeaux. Pôle de Santé Publique. COREVIH Aquitaine. France / INSERM. ISPED. Centre Inserm U897- Epidemiologie-Biostatistique & CIC-EC7. France. | pt_BR |
| Subject | HIV | pt_BR |
| Subject | AIDS | pt_BR |
| Subject | Antiretroviral therapy | pt_BR |
| Subject | Severe morbidity | pt_BR |
| Subject | Hospitalization | pt_BR |
| Subject | Cohort study | pt_BR |
| Subject | Brazil | pt_BR |
| Subject | France | pt_BR |
| e-ISSN | 1471-2334 | |
