Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006
Autor(a) principal: | |
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Data de Publicação: | 2007 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/17633 |
Resumo: | PURPOSE: To characterize the population of HIV+ Brazilian patients with late introduction of antiretroviral therapy (ARVT), using information from the Laboratory Exam Control System. METHODS: The study analyzed 84,694 patients, representing all individuals in Brazil age 15 or over with an initial CD4+ T lymphocyte count requested between 2003 and 2006, and whose ARVT start date was later than their initial CD4+ T cell count. These patients were considered antiretroviral treatment naive. The initial CD4+ T cell distribution was analyzed according to sex, age, region and year. RESULTS: Most of the patients were between 15 and 49 years of age (91%); 56% were males; 76% were asymptomatic; 50% lived in the Southeastern region of the country, with an additional 20% in the South. Initial CD4+ counts for one-third of the patients were less than 200 cells/mm³. When combined with the number of symptomatic individuals, 41% of the total group was in need of immediate ARVT. This group included 47% of the men and 53% of the patients aged 50 years and over. CONCLUSIONS: Despite universal access to ARVT in Brazil, results show that a high proportion of patients initiate ARVT at an advanced stage of disease, indicating the need to develop strategies to promote early diagnosis of HIV infection nationwide. |
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Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 Atraso na introdução de terapia antiretroviral em pacientes infectados pelo HIV no Brasil, 2003-2006 Linfócitos T CD4 HIVAidsTerapia anti-retroviralBrasilCD4 T lymphocytesHIVAIDSAntiretroviral therapyBrazil PURPOSE: To characterize the population of HIV+ Brazilian patients with late introduction of antiretroviral therapy (ARVT), using information from the Laboratory Exam Control System. METHODS: The study analyzed 84,694 patients, representing all individuals in Brazil age 15 or over with an initial CD4+ T lymphocyte count requested between 2003 and 2006, and whose ARVT start date was later than their initial CD4+ T cell count. These patients were considered antiretroviral treatment naive. The initial CD4+ T cell distribution was analyzed according to sex, age, region and year. RESULTS: Most of the patients were between 15 and 49 years of age (91%); 56% were males; 76% were asymptomatic; 50% lived in the Southeastern region of the country, with an additional 20% in the South. Initial CD4+ counts for one-third of the patients were less than 200 cells/mm³. When combined with the number of symptomatic individuals, 41% of the total group was in need of immediate ARVT. This group included 47% of the men and 53% of the patients aged 50 years and over. CONCLUSIONS: Despite universal access to ARVT in Brazil, results show that a high proportion of patients initiate ARVT at an advanced stage of disease, indicating the need to develop strategies to promote early diagnosis of HIV infection nationwide. OBJETIVO: Caracterizar a população de indivíduos infectados pelo HIV que inicia tardiamente a terapia com anti-retrovirais (TARV) no Brasil, utilizando informações do Sistema de Controle de Exames Laboratoriais. MÉTODOS: Foram analisados todos os indivíduos de 15 anos ou mais de idade que realizaram exame inicial para contagem de linfócitos T CD4+ para avaliação de indicação de tratamento entre os anos de 2003 e 2006, cuja data de início da terapia foi posterior ou igual à data de solicitação da contagem de células T CD4+ (84694 pacientes). Esses pacientes foram considerados como virgens de tratamento com anti-retrovirais. A distribuição da contagem inicial de linfócitos T CD4+ foi analisada por sexo, idade, Grande Região e ano de realização do exame. RESULTADOS: A maioria dos pacientes tinha entre 15 e 49 anos de idade (91%); 56% eram do sexo masculino; 76% assintomáticos; 50% residiam na Região Sudeste e 20% na Região Sul. A proporção de indivíduos cujo resultado do primeiro exame para contagem de linfócitos TCD4+ era inferior a 200 cel/mm³ foi de 33%. Somando-se a esses os indivíduos sintomáticos, o valor atinge 41% para a totalidade; 47% para os homens e 53% para os pacientes com mais de 50 anos de idade. CONCLUSÕES: Em que pese o acesso universal à TARV, no Brasil, os resultados mostram que uma alta proporção de pacientes inicia o tratamento em um estádio avançado da doença, apontando para a necessidade do estabelecimento de estratégias de diagnóstico precoce da infecção pelo HIV. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2007-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/1763310.1590/S1807-59322007000500008Clinics; v. 62 n. 5 (2007); 579-584 Clinics; Vol. 62 Núm. 5 (2007); 579-584 Clinics; Vol. 62 No. 5 (2007); 579-584 1980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/17633/19697Souza-Jr, Paulo Roberto BorgesSzwarcwald, Celia LandmannCastilho, Euclides Ayresinfo:eu-repo/semantics/openAccess2012-05-22T18:15:48Zoai:revistas.usp.br:article/17633Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-05-22T18:15:48Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 Atraso na introdução de terapia antiretroviral em pacientes infectados pelo HIV no Brasil, 2003-2006 |
title |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 |
spellingShingle |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 Souza-Jr, Paulo Roberto Borges Linfócitos T CD4 HIV Aids Terapia anti-retroviral Brasil CD4 T lymphocytes HIV AIDS Antiretroviral therapy Brazil |
title_short |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 |
title_full |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 |
title_fullStr |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 |
title_full_unstemmed |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 |
title_sort |
Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006 |
author |
Souza-Jr, Paulo Roberto Borges |
author_facet |
Souza-Jr, Paulo Roberto Borges Szwarcwald, Celia Landmann Castilho, Euclides Ayres |
author_role |
author |
author2 |
Szwarcwald, Celia Landmann Castilho, Euclides Ayres |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Souza-Jr, Paulo Roberto Borges Szwarcwald, Celia Landmann Castilho, Euclides Ayres |
dc.subject.por.fl_str_mv |
Linfócitos T CD4 HIV Aids Terapia anti-retroviral Brasil CD4 T lymphocytes HIV AIDS Antiretroviral therapy Brazil |
topic |
Linfócitos T CD4 HIV Aids Terapia anti-retroviral Brasil CD4 T lymphocytes HIV AIDS Antiretroviral therapy Brazil |
description |
PURPOSE: To characterize the population of HIV+ Brazilian patients with late introduction of antiretroviral therapy (ARVT), using information from the Laboratory Exam Control System. METHODS: The study analyzed 84,694 patients, representing all individuals in Brazil age 15 or over with an initial CD4+ T lymphocyte count requested between 2003 and 2006, and whose ARVT start date was later than their initial CD4+ T cell count. These patients were considered antiretroviral treatment naive. The initial CD4+ T cell distribution was analyzed according to sex, age, region and year. RESULTS: Most of the patients were between 15 and 49 years of age (91%); 56% were males; 76% were asymptomatic; 50% lived in the Southeastern region of the country, with an additional 20% in the South. Initial CD4+ counts for one-third of the patients were less than 200 cells/mm³. When combined with the number of symptomatic individuals, 41% of the total group was in need of immediate ARVT. This group included 47% of the men and 53% of the patients aged 50 years and over. CONCLUSIONS: Despite universal access to ARVT in Brazil, results show that a high proportion of patients initiate ARVT at an advanced stage of disease, indicating the need to develop strategies to promote early diagnosis of HIV infection nationwide. |
publishDate |
2007 |
dc.date.none.fl_str_mv |
2007-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/17633 10.1590/S1807-59322007000500008 |
url |
https://www.revistas.usp.br/clinics/article/view/17633 |
identifier_str_mv |
10.1590/S1807-59322007000500008 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/17633/19697 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; v. 62 n. 5 (2007); 579-584 Clinics; Vol. 62 Núm. 5 (2007); 579-584 Clinics; Vol. 62 No. 5 (2007); 579-584 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1787713168408051712 |