Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil

Detalhes bibliográficos
Autor(a) principal: Cardoso, Sandra Wagner
Data de Publicação: 2014
Outros Autores: Luz, Paula Mendes, Velasque, Luciane, Torres, Thiago, Coelho, Lara, Freedberg, Kenneth A., Santos, Valdiléa Gonçalves Veloso dos, Walensky, Rochelle P., Grinsztejn, Beatriz
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/11189
Resumo: BG acknowledges funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). PML acknowledges funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). KAF and RPW acknowledge funding from National Institute of Allergy and Infectious Diseases (NIAID, R01 AI058736, R01 AI093269).
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spelling Cardoso, Sandra WagnerLuz, Paula MendesVelasque, LucianeTorres, ThiagoCoelho, LaraFreedberg, Kenneth A.Santos, Valdiléa Gonçalves Veloso dosWalensky, Rochelle P.Grinsztejn, Beatriz2015-07-09T14:23:53Z2015-07-09T14:23:53Z2014CARDOSO, Sandra Wagner et al. Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil. AIDS Research and Therapy, v.11, n.29, p.1-10, 2014.1742-6405https://www.arca.fiocruz.br/handle/icict/1118910.1186/1742-6405-11-291742-6405BG acknowledges funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). PML acknowledges funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). KAF and RPW acknowledge funding from National Institute of Allergy and Infectious Diseases (NIAID, R01 AI058736, R01 AI093269).Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Departamento de Matemática e Estatística. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilMassachusetts General Hospital and the Harvard University. Center for AIDS Research. Harvard Medical School. The Divisions of Infectious Disease and General Medicine. Medical Practice Evaluation Center. Department of Medicine. Boston, MA, United States of AmericaFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilMassachusetts General Hospital and the Harvard University. Center for AIDS Research. Harvard Medical School. The Divisions of Infectious Disease and General Medicine. Medical Practice Evaluation Center. Department of Medicine. Boston, MA, United States of AmericaFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, BrasilBackground While Brazil has had a long-standing policy of free access to antiretroviral therapy (ART) for all in need, the epidemiological impact of ART on human immunodeficiency virus (HIV) RNA suppression in this middle-income country has not been well evaluated. We estimate first-line ART effectiveness in a large Brazilian cohort and examine the socio-demographic, behavioral, clinical and structural factors associated with virologic suppression. Methods Virologic suppression on first-line ART at 6, 12, and 24 months from start of ART was defined as having a viral load measurement ≤400 copies/mL without drug class modification and/or discontinuation. Drug class modification and/or discontinuation were defined based on the class of a particular drug. Quasi-Poisson regression was used to quantify the association of factors with virologic suppression. Results From January 2000 through June 2010, 1311 patients started first-line ART; 987 (75%) patients used NNRTI-based regimens. Virologic suppression was achieved by 77%, 76% and 68% of patients at 6, 12 and 24 months, respectively. Factors associated with virologic suppression at 12 months were: >8 years of formal education (compared to <4 years, risk ratio (RR) 1.13, 95% confidence interval (95% CI) 1.03-1.24), starting ART in 2005-2010 (compared to 2000-2004, RR 1.25 95% CI 1.15-1.35), and clinical trial participation (compared to no participation, RR 1.08 95% CI 1.01-1.16). Also at 12 months, women showed less virologic suppression compared to heterosexual men (RR 0.90 95% CI 0.82-0.99). For the 24-month endpoint, in addition to higher education, starting ART in the later period, and clinical trial participation, older age and an NNRTI-based regimen were also independently associated with virologic suppression. Conclusions Our results show that in Brazil, a middle-income country with free access to treatment, over three-quarters of patients receiving routine care reached virologic suppression on first-line ART by the end of the first year. Higher education, more recent ART initiation and clinical trial participation were associated with improved outcomes both for the 12-month and the 24-month endpoints, suggesting that further studies are needed to understand what aspects relating to these factors lead to higher virologic suppression.engBioMed CentralEffectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleHIVAntiretroviral Therapy, Highly ActiveEffectivenessBrazil/ethnologyHIVTerapia Antirretroviral de Alta AtividadeEfetividadeBrasil/etnologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82354https://www.arca.fiocruz.br/bitstream/icict/11189/1/license.txt8b4c200b4e10021c5683c6ccaba07169MD51ORIGINALEffectiveness of first-line antiretroviral therapy in.pdfEffectiveness of first-line antiretroviral therapy in.pdfapplication/pdf246957https://www.arca.fiocruz.br/bitstream/icict/11189/2/Effectiveness%20of%20first-line%20antiretroviral%20therapy%20in.pdfc593ebbc86671de78078ef2e22095c40MD52TEXTEffectiveness of first-line antiretroviral therapy in.pdf.txtEffectiveness of first-line antiretroviral therapy in.pdf.txtExtracted texttext/plain48213https://www.arca.fiocruz.br/bitstream/icict/11189/3/Effectiveness%20of%20first-line%20antiretroviral%20therapy%20in.pdf.txta92385c7679c0ca703741376ef8a7688MD53icict/111892023-06-15 16:16:51.325oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-06-15T19:16:51Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
title Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
spellingShingle Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
Cardoso, Sandra Wagner
HIV
Antiretroviral Therapy, Highly Active
Effectiveness
Brazil/ethnology
HIV
Terapia Antirretroviral de Alta Atividade
Efetividade
Brasil/etnologia
title_short Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
title_full Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
title_fullStr Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
title_full_unstemmed Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
title_sort Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil
author Cardoso, Sandra Wagner
author_facet Cardoso, Sandra Wagner
Luz, Paula Mendes
Velasque, Luciane
Torres, Thiago
Coelho, Lara
Freedberg, Kenneth A.
Santos, Valdiléa Gonçalves Veloso dos
Walensky, Rochelle P.
Grinsztejn, Beatriz
author_role author
author2 Luz, Paula Mendes
Velasque, Luciane
Torres, Thiago
Coelho, Lara
Freedberg, Kenneth A.
Santos, Valdiléa Gonçalves Veloso dos
Walensky, Rochelle P.
Grinsztejn, Beatriz
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Cardoso, Sandra Wagner
Luz, Paula Mendes
Velasque, Luciane
Torres, Thiago
Coelho, Lara
Freedberg, Kenneth A.
Santos, Valdiléa Gonçalves Veloso dos
Walensky, Rochelle P.
Grinsztejn, Beatriz
dc.subject.en.pt_BR.fl_str_mv HIV
Antiretroviral Therapy, Highly Active
Effectiveness
Brazil/ethnology
topic HIV
Antiretroviral Therapy, Highly Active
Effectiveness
Brazil/ethnology
HIV
Terapia Antirretroviral de Alta Atividade
Efetividade
Brasil/etnologia
dc.subject.decs.pt_BR.fl_str_mv HIV
Terapia Antirretroviral de Alta Atividade
Efetividade
Brasil/etnologia
description BG acknowledges funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). PML acknowledges funding from the National Council of Technological and Scientific Development (CNPq) and the Research Funding Agency of the State of Rio de Janeiro (FAPERJ). KAF and RPW acknowledge funding from National Institute of Allergy and Infectious Diseases (NIAID, R01 AI058736, R01 AI093269).
publishDate 2014
dc.date.issued.fl_str_mv 2014
dc.date.accessioned.fl_str_mv 2015-07-09T14:23:53Z
dc.date.available.fl_str_mv 2015-07-09T14:23:53Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv CARDOSO, Sandra Wagner et al. Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil. AIDS Research and Therapy, v.11, n.29, p.1-10, 2014.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/11189
dc.identifier.issn.none.fl_str_mv 1742-6405
dc.identifier.doi.none.fl_str_mv 10.1186/1742-6405-11-29
dc.identifier.eissn.none.fl_str_mv 1742-6405
identifier_str_mv CARDOSO, Sandra Wagner et al. Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil. AIDS Research and Therapy, v.11, n.29, p.1-10, 2014.
1742-6405
10.1186/1742-6405-11-29
url https://www.arca.fiocruz.br/handle/icict/11189
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
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