Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy

Detalhes bibliográficos
Autor(a) principal: Mendicino,Cássia Cristina Pinto
Data de Publicação: 2020
Outros Autores: Silva,Gabriella Jomara da, Braga,Letícia Penna, Colosimo,Enrico Antônio, Guimarães,Mark Drew Crosland, Pádua,Cristiane Aparecida Menezes de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Sociedade Brasileira de Medicina Tropical
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388
Resumo: Abstract INTRODUCTION The first Brazilian HIV treatment recommendation was put forward in 1996, resulting in 12 subsequent guidelines. Several changes were made regarding “when” and “how” to begin treatment. The latest guideline recommends immediate initiation of antiretroviral therapy (ART). This study aimed to describe the evolution of HIV treatment among people living with HIV (PLHIV) who initiated ART between 2004 and 2018 based on the national guideline recommendations concerning T-CD4+ and VL measurements. METHODS A cross-sectional analysis of data of PLHIV aged >18 years, in Minas Gerais who received ART between 2004 and 2018 was conducted. Clinical, therapeutic, and demographic information were obtained from national healthcare databases. The study was divided into four periods: 2004-2007, 2008-2012, 2013-2016, and 2017-2018. Descriptive analyses were performed. RESULTS A total of 60,618 PLHIV initiated ART (67% male and 48% aged 25-39 years), 36% of whom had CD4 counts at ART initiation and 51% documented VL after ART initiation. The median CD4 count ranged from 288 to 373 cells/µL. The median time to ART initiation decreased from 604 to 28 days and was lower among males (p <0.01). The median time from ART initiation to the first VL result decreased from 101 to 62 days over the study period, while the median VL after ART initiation ranged from 2.3 to 1.7 log10 copies/ml. CONCLUSIONS Although our results demonstrated that most recommendations were followed, there seemed to be little impact on CD4 counts and VL testing. This may result in an inadequate evaluation of ART effectiveness.
id SBMT-1_feb8e7b4c888755423bdbfb9b7ca5d90
oai_identifier_str oai:scielo:S0037-86822020000100388
network_acronym_str SBMT-1
network_name_str Revista da Sociedade Brasileira de Medicina Tropical
repository_id_str
spelling Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral TherapyCD4 lymphocyte countHIV-1Highly active antiretroviral therapyViral loadAbstract INTRODUCTION The first Brazilian HIV treatment recommendation was put forward in 1996, resulting in 12 subsequent guidelines. Several changes were made regarding “when” and “how” to begin treatment. The latest guideline recommends immediate initiation of antiretroviral therapy (ART). This study aimed to describe the evolution of HIV treatment among people living with HIV (PLHIV) who initiated ART between 2004 and 2018 based on the national guideline recommendations concerning T-CD4+ and VL measurements. METHODS A cross-sectional analysis of data of PLHIV aged >18 years, in Minas Gerais who received ART between 2004 and 2018 was conducted. Clinical, therapeutic, and demographic information were obtained from national healthcare databases. The study was divided into four periods: 2004-2007, 2008-2012, 2013-2016, and 2017-2018. Descriptive analyses were performed. RESULTS A total of 60,618 PLHIV initiated ART (67% male and 48% aged 25-39 years), 36% of whom had CD4 counts at ART initiation and 51% documented VL after ART initiation. The median CD4 count ranged from 288 to 373 cells/µL. The median time to ART initiation decreased from 604 to 28 days and was lower among males (p <0.01). The median time from ART initiation to the first VL result decreased from 101 to 62 days over the study period, while the median VL after ART initiation ranged from 2.3 to 1.7 log10 copies/ml. CONCLUSIONS Although our results demonstrated that most recommendations were followed, there seemed to be little impact on CD4 counts and VL testing. This may result in an inadequate evaluation of ART effectiveness.Sociedade Brasileira de Medicina Tropical - SBMT2020-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388Revista da Sociedade Brasileira de Medicina Tropical v.53 2020reponame:Revista da Sociedade Brasileira de Medicina Tropicalinstname:Sociedade Brasileira de Medicina Tropical (SBMT)instacron:SBMT10.1590/0037-8682-0360-2020info:eu-repo/semantics/openAccessMendicino,Cássia Cristina PintoSilva,Gabriella Jomara daBraga,Letícia PennaColosimo,Enrico AntônioGuimarães,Mark Drew CroslandPádua,Cristiane Aparecida Menezes deeng2020-12-08T00:00:00Zoai:scielo:S0037-86822020000100388Revistahttps://www.sbmt.org.br/portal/revista/ONGhttps://old.scielo.br/oai/scielo-oai.php||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br1678-98490037-8682opendoar:2020-12-08T00:00Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)false
dc.title.none.fl_str_mv Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
title Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
spellingShingle Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
Mendicino,Cássia Cristina Pinto
CD4 lymphocyte count
HIV-1
Highly active antiretroviral therapy
Viral load
title_short Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
title_full Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
title_fullStr Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
title_full_unstemmed Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
title_sort Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
author Mendicino,Cássia Cristina Pinto
author_facet Mendicino,Cássia Cristina Pinto
Silva,Gabriella Jomara da
Braga,Letícia Penna
Colosimo,Enrico Antônio
Guimarães,Mark Drew Crosland
Pádua,Cristiane Aparecida Menezes de
author_role author
author2 Silva,Gabriella Jomara da
Braga,Letícia Penna
Colosimo,Enrico Antônio
Guimarães,Mark Drew Crosland
Pádua,Cristiane Aparecida Menezes de
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Mendicino,Cássia Cristina Pinto
Silva,Gabriella Jomara da
Braga,Letícia Penna
Colosimo,Enrico Antônio
Guimarães,Mark Drew Crosland
Pádua,Cristiane Aparecida Menezes de
dc.subject.por.fl_str_mv CD4 lymphocyte count
HIV-1
Highly active antiretroviral therapy
Viral load
topic CD4 lymphocyte count
HIV-1
Highly active antiretroviral therapy
Viral load
description Abstract INTRODUCTION The first Brazilian HIV treatment recommendation was put forward in 1996, resulting in 12 subsequent guidelines. Several changes were made regarding “when” and “how” to begin treatment. The latest guideline recommends immediate initiation of antiretroviral therapy (ART). This study aimed to describe the evolution of HIV treatment among people living with HIV (PLHIV) who initiated ART between 2004 and 2018 based on the national guideline recommendations concerning T-CD4+ and VL measurements. METHODS A cross-sectional analysis of data of PLHIV aged >18 years, in Minas Gerais who received ART between 2004 and 2018 was conducted. Clinical, therapeutic, and demographic information were obtained from national healthcare databases. The study was divided into four periods: 2004-2007, 2008-2012, 2013-2016, and 2017-2018. Descriptive analyses were performed. RESULTS A total of 60,618 PLHIV initiated ART (67% male and 48% aged 25-39 years), 36% of whom had CD4 counts at ART initiation and 51% documented VL after ART initiation. The median CD4 count ranged from 288 to 373 cells/µL. The median time to ART initiation decreased from 604 to 28 days and was lower among males (p <0.01). The median time from ART initiation to the first VL result decreased from 101 to 62 days over the study period, while the median VL after ART initiation ranged from 2.3 to 1.7 log10 copies/ml. CONCLUSIONS Although our results demonstrated that most recommendations were followed, there seemed to be little impact on CD4 counts and VL testing. This may result in an inadequate evaluation of ART effectiveness.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0037-8682-0360-2020
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
publisher.none.fl_str_mv Sociedade Brasileira de Medicina Tropical - SBMT
dc.source.none.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical v.53 2020
reponame:Revista da Sociedade Brasileira de Medicina Tropical
instname:Sociedade Brasileira de Medicina Tropical (SBMT)
instacron:SBMT
instname_str Sociedade Brasileira de Medicina Tropical (SBMT)
instacron_str SBMT
institution SBMT
reponame_str Revista da Sociedade Brasileira de Medicina Tropical
collection Revista da Sociedade Brasileira de Medicina Tropical
repository.name.fl_str_mv Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)
repository.mail.fl_str_mv ||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br
_version_ 1752122162467045376