| Author | Avila, Dorita | |
| Author | Althoff, Keri N | |
| Author | Mugglin, Catrina | |
| Author | Kaloustian, Kara Wools- | |
| Author | Koller, Manuel | |
| Author | Dabis, François | |
| Author | Nash, Denis | |
| Author | Gsponer, Thomas | |
| Author | Sungkanuparph, Somnuek | |
| Author | McGowan, Catherine | |
| Author | May, Margaret | |
| Author | Cooper, David | |
| Author | Chimbetete, Cleophas | |
| Author | Wolff, Marcelo | |
| Author | Collier, Ann | |
| Author | McManus, Hamish | |
| Author | Davies, Mary-Ann | |
| Author | Dominique, Costagliola | |
| Author | Ramírez, Brenda Crabtree | |
| Author | Chaiwarith, Romanee | |
| Author | Cescon, Angela | |
| Author | Cornell, Morna | |
| Author | Diero, Lameck | |
| Author | Phanuphak, Praphan | |
| Author | Sawadogo, Adrien | |
| Author | Ehmer, Jochen | |
| Author | Eholié, Serge Paul | |
| Author | Li, Patrick CK | |
| Author | Fox, Matthew P. | |
| Author | Ghandi, Neel E. | |
| Author | González, Elsa | |
| Author | Lee, Christopher KC | |
| Author | Hoffmann, Christopher J. | |
| Author | Kambugum, Andrew | |
| Author | Keiser, Olivia | |
| Author | Ditangco, Rossana | |
| Author | Prozesky, Hans | |
| Author | Lampe, Fiona | |
| Author | Kumarasamy, Nagalingeswaran | |
| Author | Kitahata, Mari | |
| Author | Lugina, Emmanuel | |
| Author | Lyamuya, Rita | |
| Author | Vonthanak, Saphonn | |
| Author | Fink, Valeria | |
| Author | Monforte, Antonella d’Arminio | |
| Author | Luz, Paula Mendes | |
| Author | Chen, Yi-Ming Arthur | |
| Author | Minga, Albert | |
| Author | Casabona, Jordi | |
| Author | Mwango, Albert | |
| Author | Choi, Jun Y. | |
| Author | Newell, Marie-Louise | |
| Author | Bukusi, Elizabeth A. | |
| Author | Ngonyani, Kapella | |
| Author | Merati, Tuti P. | |
| Author | Otieno, Juliana | |
| Author | Bosco, Mwebesa B. | |
| Author | Phiri, Sam | |
| Author | Ng, Oon T. | |
| Author | Anastos, Kathryn | |
| Author | Rockstroh, Jürgen | |
| Author | Santos, Ignacio | |
| Author | Oka, Shinichi | |
| Author | Somi, Geoffrey | |
| Author | Stephan, Christoph | |
| Author | Teira, Ramon | |
| Author | Wabwire, Deo | |
| Author | Wandeler, Gilles | |
| Author | Boulle, Andrew | |
| Author | Reiss, Peter | |
| Author | Wood, Robin | |
| Author | Chi, Benjamin H. | |
| Author | Williams, Carolyn | |
| Author | Sterne, Jonathan A. | |
| Author | Egger, Matthias | |
| Access date | 2015-04-14T15:13:51Z | |
| Available date | 2015-04-14T15:13:51Z | |
| Document date | 2014 | |
| Citation | AVILA, Dorita et al. Immunodeficiency at the start of combination antiretroviral therapy in low-, middle- and high-income countries. Journal of acquired immune deficiency syndromes, v.65, n.1, p.1–19, 2014. | pt_BR |
| ISSN | 1525-4135 | |
| URI | https://www.arca.fiocruz.br/handle/icict/9992 | |
| Language | eng | pt_BR |
| Publisher | Lippincott, Williams & Wilkins | pt_BR |
| Rights | open access | pt_BR |
| Title | Immunodeficiency at the start of combination antiretroviral therapy in low-, middle- and high-income countries | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1097/QAI.0b013e3182a39979 | |
| Abstract | Objective: To describe the CD4 cell count at the start of combination antiretroviral therapy (cART) in low-income (LIC), lower middle-income (LMIC), upper middle-income (UMIC), and high-income (HIC) countries.
Methods: Patients aged 16 years or older starting cART in a clinic participating in a multicohort collaboration spanning 6 continents (International epidemiological Databases to Evaluate AIDS and ART Cohort Collaboration) were eligible. Multilevel linear regression models were adjusted for age, gender, and calendar year; missing CD4 counts were imputed.
Results: In total, 379,865 patients from 9 LIC, 4 LMIC, 4 UMIC, and 6 HIC were included. In LIC, the median CD4 cell count at cART initiation increased by 83% from 80 to 145 cells/μL between 2002 and 2009. Corresponding increases in LMIC, UMIC, and HIC were from 87 to 155 cells/μL (76% increase), 88 to 135 cells/μL (53%), and 209 to 274 cells/μL (31%). In 2009, compared with LIC, median counts were 13 cells/μL [95% confidence interval (CI): −56 to +30] lower in LMIC, 22 cells/μL (−62 to +18) lower in UMIC, and 112 cells/μL (+75 to +149) higher in HIC. They were 23 cells/μL (95% CI: +18 to +28 cells/μL) higher in women than men. Median counts were 88 cells/μL (95% CI: +35 to +141 cells/μL) higher in countries with an estimated national cART coverage >80%, compared with countries with <40% coverage.
Conclusions: Median CD4 cell counts at the start of cART increased 2000–2009 but remained below 200 cells/μL in LIC and MIC and below 300 cells/μL in HIC. Earlier start of cART will require substantial efforts and resources globally. | pt_BR |
| Affilliation | University of Bern. Institute of Social and Preventive Medicine. Finkenhubelweg, BE, Switzerland | pt_BR |
| Affilliation | Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, BC, United States of America | pt_BR |
| Affilliation | University of Bern. Institute of Social and Preventive Medicine. Finkenhubelweg, BE, Switzerland | pt_BR |
| Affilliation | Indiana University School of Medicine. Indianapolis, IN, United States of America | pt_BR |
| Affilliation | University of Bern. Institute of Social and Preventive Medicine. Finkenhubelweg, BE, Switzerland | pt_BR |
| Affilliation | Université Bordeaux Segalen. Institut de Santé Publique. Epidémiologie et Développement. Bordeaux, BOD, France | pt_BR |
| Affilliation | CUNY School of Public Health. New York, NY, United States of America | pt_BR |
| Affilliation | University of Bern. Institute of Social and Preventive Medicine. Finkenhubelweg, BE, Switzerland | pt_BR |
| Affilliation | Mahidol University. Faculty of Medicine Ramathibodi Hospital. Bangkok, BKK, Thailand | pt_BR |
| Affilliation | Vanderbilt University School of Medicine. Nashville, TN, United States of America | pt_BR |
| Affilliation | University of Bristol. School of Social and Community Medicine. Bristol, BS, United Kingdom | pt_BR |
| Affilliation | The University of New South Wales. The Kirby Institute. Sydney, SYD, Australia | pt_BR |
| Affilliation | Newlands Clinic. Harare, HA, Zimbabwe | pt_BR |
| Affilliation | Universidad de Chile. Fundación Arriarán. Santiago, SA, Chile | pt_BR |
| Affilliation | University of Washington School of Medicine Center. Seattle, SEA, United States of America | pt_BR |
| Affilliation | The University of New South Wales. The Kirby Institute. Sydney, SYD, Australia | pt_BR |
| Affilliation | University of Cape Town. School of Public Health and Family Medicine. Centre for Infectious Disease Epidemiology and Research. Cape Town, CPT, South Africa | pt_BR |
| Affilliation | University Pierre et Marie Curie. Paris, PAR, France | pt_BR |
| Affilliation | Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México, DF, México | pt_BR |
| Affilliation | Research Institute for Health Sciences. Chiang Mai, CNX, Thailand | pt_BR |
| Affilliation | British Columbia Centre for Excellence in HIV/AIDS. Vancouver, VAN, Canada | pt_BR |
| Affilliation | University of Cape Town. School of Public Health and Family Medicine. Centre for Infectious Disease Epidemiology and Research. Cape Town, CPT, South Africa | pt_BR |
| Affilliation | Moi University. Academic Model Providing Access to Health Care. School of Medicine. Faculty of Health Sciences. Eldoret, EDL, Kenya | pt_BR |
| Affilliation | The HIV Netherlands Australia Thailand Research Collaboration Red Cross. AIDS Research Centre. Bangkok, BKK, Thailand | pt_BR |
| Affilliation | CHU Sourô Sanou. Bobo-Dioulasso, BOY, Burkina Faso | pt_BR |
| Affilliation | SolidarMed. African HIV prevention and treatment program. Lucerne, QLJ, Switzerland | pt_BR |
| Affilliation | Service de Maladies Infectieuses et Tropicales. Abidjan, ABJ, Côte d’Ivoire | pt_BR |
| Affilliation | Queen Elizabeth Hospital. Hong Kong, HK, China | pt_BR |
| Affilliation | Boston University. Boston University School of Public Health. Center for Global Health and Development. Department of Epidemiology. Boston, BOS, United States of America / University of the Witwatersrand. Health Economics and Epidemiology Research Office. Johannesburg, JHB, South Africa | pt_BR |
| Affilliation | Emory University Rollins School of Public Health. Global Health & Infectious Diseases. Departments of Epidemiology. Atlanta, ATL, United States of America | pt_BR |
| Affilliation | Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, LIM, Peru | pt_BR |
| Affilliation | Hospital Sungai Buloh. Sungai Buloh, SGB, Malaysia | pt_BR |
| Affilliation | Aurum Institute. Johannesburg, JHB, South Africa / John Hopkins University School of Medicine, Baltimore, BC, United States of America | pt_BR |
| Affilliation | Infectious Diseases Institute, Kampala, KLA, Uganda | pt_BR |
| Affilliation | University of Bern. Institute of Social and Preventive Medicine. Finkenhubelweg, BE, Switzerland | pt_BR |
| Affilliation | Research Institute for Tropical Medicine. Manila, MNL, Philippines | pt_BR |
| Affilliation | University of Stellenbosch and Tygerberg Hospital. Division of Infectious Diseases. Cape Town, CPT, South Africa | pt_BR |
| Affilliation | University College London. Research Department of Infection and Population Health, London, LND, United Kingdom | pt_BR |
| Affilliation | YRG Centre for AIDS Research and Education. Chennai, CH, India | pt_BR |
| Affilliation | University of Washington School of Medicine Center. Seattle, SEA, United States of America | pt_BR |
| Affilliation | Ocean Road Cancer Institute. Dar-es-Salaam, DAR, Tanzania | pt_BR |
| Affilliation | Morogoro Regional Hospital. Morogoro, MORO, Tanzania | pt_BR |
| Affilliation | National Center for HIV/AIDS. Dermatology & STDs. Phnom Penh, PNH, Cambodia | pt_BR |
| Affilliation | Fundación Huésped. Buenos Aires, BA, Argentina | pt_BR |
| Affilliation | University of Milan. San Paolo Hospital. Clinic of Infectious Diseases & Tropical Medicine. Milano, MI, Italy | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil | pt_BR |
| Affilliation | Taipei Veterans General Hospital and AIDS Prevention and Research Centre. National Yang-Ming University. Taipei, TPE, Taiwan | pt_BR |
| Affilliation | Centre Médical de Suivi de Donneurs de Sang. Abidjan, ABJ, Cote d’Ivoire | pt_BR |
| Affilliation | Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya. Badalona, BAD, Spain / CIBER Epidemiología y Salud Pública. Barcelona, BAR, Spain | pt_BR |
| Affilliation | Zambian Ministry of Health. Lusaka, LUN, Zambia | pt_BR |
| Affilliation | Yonsei University College of Medicine. Department of Internal Medicine. Division of Infectious Diseases. Seoul, SEL, South Korea | pt_BR |
| Affilliation | University of KwaZulu-Natal. Africa Centre for Health and Population Studies. Mtubatuba, MTU, South Africa | pt_BR |
| Affilliation | Family AIDS Care and Education Services. Kisumu, KIS, Kenya | pt_BR |
| Affilliation | Tumbi Regional Hospital. Kibaha, KIB, Tanzania | pt_BR |
| Affilliation | Faculty of Medicine Udayana University & Sanglah Hospital. Bali, BAL, Indonesia | pt_BR |
| Affilliation | Nyanza Provincial Hospital. Kisumu, KIS, Kenya | pt_BR |
| Affilliation | Mbarara University of Science and Technology. ISS Clinic. Mbarara, MBQ, Uganda | pt_BR |
| Affilliation | Lighthouse Trust. Lilongwe, LLW, Malawi | pt_BR |
| Affilliation | Tan Tock Seng Hospital. Singapore, SI, Singapore | pt_BR |
| Affilliation | Albert Einstein College of Medicine. Departments of Medicine and Epidemiology and Population Health. New York, NY, United States of America | pt_BR |
| Affilliation | University Hospital Bonn. Department of Internal Medicine I. Bonn, BNN, Germany | pt_BR |
| Affilliation | Hospital La Princesa. Madrid, MAD, Spain | pt_BR |
| Affilliation | National Center for Global Health and Medicine. Tokyo, TYO, Japan | pt_BR |
| Affilliation | National AIDS Control Program. Dar es Salaam, DAR, Tanzania | pt_BR |
| Affilliation | HIVCENTER am Klinikum der Johann Wolfgang Goethe-Universität. Frankfurt, FFM, Germany | pt_BR |
| Affilliation | Hospital Sierrallana. Torrelavega, TVG, Spain | pt_BR |
| Affilliation | Mulago University JHU Collaboration. Kampala, KLA, Uganda | pt_BR |
| Affilliation | Bern University Hospital and University of Bern. Department of Infectious Diseases. Bern, BER, Switzerland | pt_BR |
| Affilliation | University of Cape Town. School of Public Health and Family Medicine. Centre for Infectious Disease Epidemiology and Research. Cape Town, CPT, South Africa | pt_BR |
| Affilliation | Academisch Medisch Centrum bij de Universiteit van Amsterdam. Amsterdam, AMS, The Netherlands | pt_BR |
| Affilliation | University of Cape Town. Desmond Tutu HIV Centre. Cape Town, CPT, South Africa | pt_BR |
| Affilliation | Center for Infectious Disease Research in Zambia. Lusaka, LUN, Zambia | pt_BR |
| Affilliation | National Institute of Allergy and Infectious Diseases. Epidemiology Branch Division of AIDS. Maryland, MD, United States of America | pt_BR |
| Affilliation | The University of New South Wales. The Kirby Institute. Sydney, SYD, Australia | pt_BR |
| Affilliation | University of Bern. Institute of Social and Preventive Medicine. Finkenhubelweg, BE, Switzerland / University of Cape Town. School of Public Health and Family Medicine. Centre for Infectious Disease Epidemiology and Research. Cape Town, CPT, South Africa | pt_BR |
| DeCS | Antiretroviral Therapy, Highly Active | pt_BR |
| DeCS | Antigens, CD4 | pt_BR |
| DeCS | Africa South of the Sahara | pt_BR |
| DeCS | North America | pt_BR |
| DeCS | West Indies | pt_BR |
| DeCS | Central America | pt_BR |
| DeCS | South America | pt_BR |
| DeCS | Europe | pt_BR |
| DeCS | Asia | pt_BR |
| e-ISSN | 1944-7884 | |
