Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2018 |
| 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/29101 |
Resumo: | Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru. |
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Carriquiry, GabrielaGiganti, Mark J.Castilho, Jessica L.Jayathilake, KaruCahn, PedroGrinsztejn, BeatrizCortes, ClaudiaPape, Jean W.Padgett, DenisSierra-Madero, JuanMcGowan, Catherine C.Shepherd, Bryan E.Gotuzzo, Eduardo2018-09-27T14:47:34Z2018-09-27T14:47:34Z2018CARRIQUIRY, Gabriela et al. Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort. Journal of the International AIDS Society, v. 21, n. 3, p. 1-9, 2018.1758-2652https://www.arca.fiocruz.br/handle/icict/2910110.1002/jia2.25088engVirologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohortinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInstituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.Vanderbilt University. Nashville, TN, USA.Vanderbilt University. Nashville, TN, USA.Vanderbilt University. Nashville, TN, USA.Fundación Huésped. Buenos Aires, Argentina.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundación Arriarán. Santiago, Chile.Le Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes Port-au-Prince. Haiti and Weill Cornell Medical College. New York, NY, USA.Instituto Hondureño de Seguridad Social and Hospital Escuela Universitario. Tegucigalpa, Honduras.Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico.Vanderbilt University. Nashville, TN, USA.Vanderbilt University. Nashville, TN, USA.Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.Introduction: The “greying” of the HIV epidemic necessitates a better understanding of the healthcare needs of older HIVpositive adults. As these individuals age, it is unclear whether comorbidities and their associated therapies or the ageing process itself alter the response to antiretroviral therapy (ART). In this study, HIV treatment outcomes and corresponding risk factors were compared between older ART initiators and those who were younger using data from the Caribbean, Central and South America Network for HIV Epidemiology (CCASAnet). Methods: HIV-positive adults (≥18 years) initiating ART at nine sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Patients were classified as older (≥50 years) or younger (<50 years) based on age at ART initiation. ART effectiveness was measured using three outcomes: death, virologic failure and ART treatment modification. Cox regression models for each outcome compared risk between older and younger patients, adjusting for other covariates. Results: Among 26,311 patients initiating ART between 1996 and 2016, 3389 (13%) were ≥50 years. The majority of patients in both ≥50 and <50 age groups received a non-nucleoside reverse transcriptase inhibitor-based regimen (89% vs. 87%), did not have AIDS at baseline (63% vs. 62%), and were male (59% vs. 58%). Older patients had a higher risk of death (adjusted hazard ratio (aHR) 1.64; 95% confidence intervals (CI): 1.48 to 1.83) and a lower risk of virologic failure (aHR: 0.73; 95% CI: 0.63 to 0.84). There was no difference in risk of ART modification (aHR: 1.00; 95% CI: 0.94 to 1.06). Risk factors for death, virologic failure and treatment modification were similar for each group. Conclusions: Older age at ART initiation was associated with increased mortality and decreased risk of virologic failure in our cohort of more than 26,000 ART initiators in Latin America and the Caribbean. To the best of our knowledge this is the first study from the region to evaluate ART outcomes in this growing and important population. Given the complexity of issues related to ageing with HIV, a greater understanding is needed in order to properly respond to this shifting epidemic.HIVAgeingOver 50Latin AmericaCaribbeanART outcomesVirologic failureinfo: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/29101/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALVirologic failure and mortality in older ART initiators_Beatriz_Grinsztejn_INI_Lapclin-AIDS_2018.pdfVirologic failure and mortality in older ART initiators_Beatriz_Grinsztejn_INI_Lapclin-AIDS_2018.pdfapplication/pdf405738https://www.arca.fiocruz.br/bitstream/icict/29101/2/Virologic%20failure%20and%20mortality%20in%20older%20ART%20initiators_Beatriz_Grinsztejn_INI_Lapclin-AIDS_2018.pdffb26c237c564e3282e94a45175b7f64fMD52TEXTVirologic failure and mortality in older ART 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| dc.title.pt_BR.fl_str_mv |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| title |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| spellingShingle |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort Carriquiry, Gabriela HIV Ageing Over 50 Latin America Caribbean ART outcomes Virologic failure |
| title_short |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| title_full |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| title_fullStr |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| title_full_unstemmed |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| title_sort |
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort |
| author |
Carriquiry, Gabriela |
| author_facet |
Carriquiry, Gabriela Giganti, Mark J. Castilho, Jessica L. Jayathilake, Karu Cahn, Pedro Grinsztejn, Beatriz Cortes, Claudia Pape, Jean W. Padgett, Denis Sierra-Madero, Juan McGowan, Catherine C. Shepherd, Bryan E. Gotuzzo, Eduardo |
| author_role |
author |
| author2 |
Giganti, Mark J. Castilho, Jessica L. Jayathilake, Karu Cahn, Pedro Grinsztejn, Beatriz Cortes, Claudia Pape, Jean W. Padgett, Denis Sierra-Madero, Juan McGowan, Catherine C. Shepherd, Bryan E. Gotuzzo, Eduardo |
| author2_role |
author author author author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Carriquiry, Gabriela Giganti, Mark J. Castilho, Jessica L. Jayathilake, Karu Cahn, Pedro Grinsztejn, Beatriz Cortes, Claudia Pape, Jean W. Padgett, Denis Sierra-Madero, Juan McGowan, Catherine C. Shepherd, Bryan E. Gotuzzo, Eduardo |
| dc.subject.en.pt_BR.fl_str_mv |
HIV Ageing Over 50 Latin America Caribbean ART outcomes Virologic failure |
| topic |
HIV Ageing Over 50 Latin America Caribbean ART outcomes Virologic failure |
| description |
Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru. |
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2018 |
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2018-09-27T14:47:34Z |
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2018-09-27T14:47:34Z |
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2018 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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CARRIQUIRY, Gabriela et al. Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort. Journal of the International AIDS Society, v. 21, n. 3, p. 1-9, 2018. |
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https://www.arca.fiocruz.br/handle/icict/29101 |
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1758-2652 |
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10.1002/jia2.25088 |
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CARRIQUIRY, Gabriela et al. Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort. Journal of the International AIDS Society, v. 21, n. 3, p. 1-9, 2018. 1758-2652 10.1002/jia2.25088 |
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