Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy
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...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Medicina Tropical (SBMT)
2020-12-01
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| Series: | Revista da Sociedade Brasileira de Medicina Tropical |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388&tlng=en |
| _version_ | 1818553866753409024 |
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| author | Cássia Cristina Pinto Mendicino Gabriella Jomara da Silva Letícia Penna Braga Enrico Antônio Colosimo Mark Drew Crosland Guimarães Cristiane Aparecida Menezes de Pádua |
| author_facet | Cássia Cristina Pinto Mendicino Gabriella Jomara da Silva Letícia Penna Braga Enrico Antônio Colosimo Mark Drew Crosland Guimarães Cristiane Aparecida Menezes de Pádua |
| author_sort | Cássia Cristina Pinto Mendicino |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-12T09:31:25Z |
| format | Article |
| id | doaj.art-d1930774fa33433e93bd1bb016ab8c93 |
| institution | Directory Open Access Journal |
| issn | 1678-9849 |
| language | English |
| last_indexed | 2024-12-12T09:31:25Z |
| publishDate | 2020-12-01 |
| publisher | Sociedade Brasileira de Medicina Tropical (SBMT) |
| record_format | Article |
| series | Revista da Sociedade Brasileira de Medicina Tropical |
| spelling | doaj.art-d1930774fa33433e93bd1bb016ab8c932022-12-22T00:28:52ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-98492020-12-015310.1590/0037-8682-0360-2020Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral TherapyCássia Cristina Pinto Mendicinohttps://orcid.org/0000-0002-1627-292XGabriella Jomara da SilvaLetícia Penna BragaEnrico Antônio ColosimoMark Drew Crosland GuimarãesCristiane Aparecida Menezes de PáduaAbstract 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388&tlng=enCD4 lymphocyte countHIV-1Highly active antiretroviral therapyViral load |
| spellingShingle | Cássia Cristina Pinto Mendicino Gabriella Jomara da Silva Letícia Penna Braga Enrico Antônio Colosimo Mark Drew Crosland Guimarães Cristiane Aparecida Menezes de Pádua Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy Revista da Sociedade Brasileira de Medicina Tropical CD4 lymphocyte count HIV-1 Highly active antiretroviral therapy Viral load |
| title | 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_short | 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 |
| topic | CD4 lymphocyte count HIV-1 Highly active antiretroviral therapy Viral load |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100388&tlng=en |
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