Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/29548
Title: Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study
Authors: Angriman, Federico
Belloso, Waldo H
Sierra-Madero, Juan
Sánchez, Jorge
Moreira, Ronaldo Ismerio
Kovalevski, Leandro O
Orellana, Liliana C
Cardoso, Sandra Wagner
Crabtree-Ramirez, Brenda
La Rosa, Alberto
Losso, Marcelo H
Affilliation: CICAL. Buenos Aires, Argentina./ Hospital Italiano de Buenos Aires. Servicio de Clínica Médica. Buenos Aires, Argentina.
CICAL. Buenos Aires, Argentina./ Hospital Italiano de Buenos Aires. Servicio de Clínica Médica. Buenos Aires, Argentina.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México.
Asociación Civil Impacta Salud y Educación. Lima, Perú.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
CICAL. Buenos Aires, Argentina.
CICAL. Buenos Aires, Argentina./ Deakin University. Melbourne, Australia.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México.
Asociación Civil Impacta Salud y Educación. Lima, Perú.
CICAL. Buenos Aires, Argentina./ Hospital José M. Ramos Mejía. Buenos Aires, Argentina.
Abstract: Nearly 2 million people are infected with human immunodeficiency virus (HIV) in Latin America. However, information regarding population-scale outcomes from a regional perspective is scarce. We aimed to describe the baseline characteristics and therapeutic outcomes of newly-treated individuals with HIV infection in Latin America. A Retrospective cohort study was undertaken. The primary explanatory variable was combination antiretroviral therapy based on either a protease inhibitor (PI) or a non-nucleoside reverse transcriptase inhibitor (NNRTI). The main outcome was defined as the composite of all-cause mortality and the occurrence of an AIDS-defining clinical event or a serious non-AIDS-defining event during the first year of therapy. The secondary outcomes included the time to a change in treatment strategy. All analyses were performed according to the intention to treat principle. A total of 937 treatment-naive patients from four participating countries were included (228 patients with PI therapy and 709 with NNRTI-based treatment). At the time of treatment initiation, the patients had a mean age of 37 (SD: 10) years and a median CD4 + T-cell count of 133 cells/mm(3) (interquartile range: 47.5-216.0). Patients receiving PI-based regimens had a significantly lower CD4 + count, a higher AIDS prevalence at baseline and a shorter time from HIV diagnosis until the initiation of treatment. There was no difference in the hazard ratio for the primary outcome between groups. The only covariates associated with the latter were CD4 + cell count at baseline, study site and age. The estimated hazard ratio for the time to a change in treatment (NNRTI vs PI) was 0.61 (95% CI 0.47-0.80, p < 0.01). This study concluded that patients living with HIV in Latin America present with similar clinical outcomes regardless of the choice of initial therapy. Patients treated with PIs are more likely to require a treatment change during the first year of follow up.
Keywords: Acquired immunodeficiency syndrome
CD4 cell lymphocyte count
Cohort studies
Latin America
Antiretroviral therapy
Issue Date: 2016
Citation: ANGRIMAN, Federico. et al. Clinical outcomes of first-line antiretroviral therapy in Latin America: analysis from the LATINA retrospective cohort study. International Journal of STD & AIDS, v. 27, n. 2, p. 118-126, 2015
DOI: 10.1177/0956462415575621
ISSN: 0956-4624
Copyright: restricted access
Appears in Collections:INI - Artigos de Periódicos



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