Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2016 |
| Outros Autores: | , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/29330 |
Resumo: | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. |
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Coelho, Lara E.Cardoso, Sandra W.Amancio, Rodrigo T.Moreira, Ronaldo I.Ribeiro, Sayonara R.Coelho, Alessandra B.Campos, Dayse P.Veloso, Valdiléa G.Grinsztejn, BeatrizLuz, Paula M.2018-10-04T13:22:30Z2018-10-04T13:22:30Z2016COELHO, Lara E. et al. Predictors of Opportunistic Illnesses Incidence in Post Combination Antiretroviral Therapy Era in an Urban Cohort from Rio de Janeiro, Brazil. BMC Infectious Diseases, v. 16, p. 1-9, 2016.1471-2334https://www.arca.fiocruz.br/handle/icict/2933010.1186/s12879-016-1462-xengPredictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Background: Opportunistic illnesses still account for a huge proportion of hospitalizations and deaths among HIVinfected patients in the post combination antiretroviral therapy (cART) era, particularly in middle- and low-income countries. The aim of this study was to assess predictors of the top four most incident opportunistic illnesses (tuberculosis, esophageal candidiasis, cerebral toxoplasmosis and Pneumocystis jiroveci pneumonia) in an HIV clinical cohort from a middle-income country in the post cART era. Methods: A total of 2835 HIV infected participants aged ≥ 18 years at enrollment were followed from January 2000 to December 2012 until the occurrence of their first opportunistic illness, death or end of study, whichever occurred first. Extended Cox proportional hazards regression models, stratified by use of cART, were fitted to assess predictors of opportunistic illness incidence during follow-up. Results: The incidence rates of tuberculosis, esophageal candidiasis, cerebral toxoplasmosis and Pneumocystis jiroveci pneumonia were 15.3, 8.6, 6.0, 4.8 per 1000 persons-year, respectively. Disease specific adjusted Cox models showed that presence of an opportunistic illness at enrollment significantly increased disease incidence while higher nadir CD4+ T lymphocyte count had a significant protective effect in patients not in use of cART. Duration of cART use also significantly reduced disease incidence. Conclusions: Our findings show that, still in the post-cART era, prevention of opportunistic infections can be achieved by preventing immune deterioration by instituting early use of cART. Interventions focusing on early diagnosis and linkage to care in addition to the prompt initiation of cART are essential to reduce the incidence of opportunistic illnesses among HIV infected patients in post-cART era.AIDS-related opportunistic infectionsAcquired immunodeficiency syndromeCohort studyCox proportional hazards regression modelsHIVIncidenceinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/29330/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALPredictors of opportunistic illnesses_Lara_Coelho_etal_INI_Lapclin_2016.pdfPredictors of opportunistic 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| dc.title.pt_BR.fl_str_mv |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| title |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| spellingShingle |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil Coelho, Lara E. AIDS-related opportunistic infections Acquired immunodeficiency syndrome Cohort study Cox proportional hazards regression models HIV Incidence |
| title_short |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| title_full |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| title_fullStr |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| title_full_unstemmed |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| title_sort |
Predictors of opportunistic illnesses incidence in post combination antiretroviral therapy era in an urban cohort from Rio de Janeiro, Brazil |
| author |
Coelho, Lara E. |
| author_facet |
Coelho, Lara E. Cardoso, Sandra W. Amancio, Rodrigo T. Moreira, Ronaldo I. Ribeiro, Sayonara R. Coelho, Alessandra B. Campos, Dayse P. Veloso, Valdiléa G. Grinsztejn, Beatriz Luz, Paula M. |
| author_role |
author |
| author2 |
Cardoso, Sandra W. Amancio, Rodrigo T. Moreira, Ronaldo I. Ribeiro, Sayonara R. Coelho, Alessandra B. Campos, Dayse P. Veloso, Valdiléa G. Grinsztejn, Beatriz Luz, Paula M. |
| author2_role |
author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Coelho, Lara E. Cardoso, Sandra W. Amancio, Rodrigo T. Moreira, Ronaldo I. Ribeiro, Sayonara R. Coelho, Alessandra B. Campos, Dayse P. Veloso, Valdiléa G. Grinsztejn, Beatriz Luz, Paula M. |
| dc.subject.en.pt_BR.fl_str_mv |
AIDS-related opportunistic infections Acquired immunodeficiency syndrome Cohort study Cox proportional hazards regression models HIV Incidence |
| topic |
AIDS-related opportunistic infections Acquired immunodeficiency syndrome Cohort study Cox proportional hazards regression models HIV Incidence |
| description |
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil. |
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2016 |
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2016 |
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2018-10-04T13:22:30Z |
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2018-10-04T13:22:30Z |
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COELHO, Lara E. et al. Predictors of Opportunistic Illnesses Incidence in Post Combination Antiretroviral Therapy Era in an Urban Cohort from Rio de Janeiro, Brazil. BMC Infectious Diseases, v. 16, p. 1-9, 2016. |
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https://www.arca.fiocruz.br/handle/icict/29330 |
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1471-2334 |
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10.1186/s12879-016-1462-x |
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COELHO, Lara E. et al. Predictors of Opportunistic Illnesses Incidence in Post Combination Antiretroviral Therapy Era in an Urban Cohort from Rio de Janeiro, Brazil. BMC Infectious Diseases, v. 16, p. 1-9, 2016. 1471-2334 10.1186/s12879-016-1462-x |
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