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Epidemiology and policy
SP3-45 AIDS-free-time in the pre and post-HAART eras in the Sao Paulo HIV cohort, Brazil
  1. M V Tancredi1,
  2. E A Waldman2
  1. 1Sao Paulo State STD and AIDS Training and Reference Center, Sao Paulo, Sao Paulo, Brazil
  2. 2School of Public Health of Sao Paulo University, Sao Paulo, Sao Paulo, Brazil

Abstract

Background The effect of ART used before aids diagnosis has been the object of studies. The objectives were to estimate AIDS incidence rates, median AIDS-free-time and to investigate predictor factors for progression to AIDS.

Methods Retrospective cohort study, encompassing 1879 adult patients of the HIV São Paulo Cohort, during 1988–2005. The Kaplan-Meier methods, the Cox proportional hazard model and HRs estimates were used.

Results 981 patients progressed to aids. AIDS incidence rates were 11.6 and 7.1 person-years in the 1988–1996 and 1997–2003 periods, respectively. The median time of progression from HIV infection to AIDS without treatment was 53.7 months; with ART without HAART, 90.0 months; and with HAART, over 50% of patients followed did not progress to AIDS until 108 months. Independent prognostic factors for AIDS-free-time were: treatment with ART without HAART (HR 2.1; 95% CI 1.6 to 2.8), no treatment regimen (HR 3.0; 95% CI 2.5 to 3.6); age at HIV infection diagnosis between 30 and 49 years (HR 1.2; 95% CI 1.1 to 1.3), age over 50 years (HR 2.9; 95% CI 2.3 to 5.2); black race/colour (HR 1.4; 95% CI 1.1 to 1.7); MSM (HR 1.4; 95% CI 1.1 to 1.6) and IDU (HR 1.7; 95% CI 1.3 to 2.2) exposure categories; up to 8 years of schooling (HR 1.3; 95% CI 1.1 to 1.5) and no schooling (HR 2.0; 95% CI 1.4 to 5.6); and CD4 count between 350 and 500 cells/mm3 (HR 1.6; 95% CI 1.3 to 1.9).

Conclusions Increased AIDS-free-time was observed, with HAART. Decrease in the incidence rates were observed, Predictor factors to AIDS were treatment, age, race/colour, transmission categories, schooling and CD4 count.

  • AIDS-free-time
  • AIDS incidence
  • HAART
  • cohort studies

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