Article Text


Epidemiology and policy
SP3-46 AIDS survival in the pre and post-HAART eras in the Sao Paulo aids 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


Background AIDS remains a great public health problem and the effect of ART has been studied. The objectives were to estimate AIDS mortality rates, median survival time and to investigate death predictor factors.

Methods Retrospective cohort study, with 6594 adult patients followed from 1988 to 2005. The Kaplan–Meier estimator, the Cox proportional hazard model and HRs estimates were used.

Results In a follow-up of 203 008 persons-year, 2936 patients progressed to death. AIDS mortality rates were 17.6, 23.2, and 7.8 person-years in the 1988–1993, 1994–1996 and 1997–2003 periods, respectively. Median progression time from AIDS to death was 13.4 months in the 1988–1993 period; 22.3 months, between 1994 and 1996, and in the 1997–2003 period, over 50% of patients followed survived. Independent predictor factors for death were: AIDS diagnosis period 1994–1996 (HR 2.0; 95% CI 1.8 to 2.2) and 1988–1993 (HR 3.2; 95% CI 2.8 to 3.5); AIDS diagnosis age between 30 and 49 years (HR 1.4; 95% CI 1.2 to 1.5), age over 50 (HR 2.0; 95% CI 1.7 to 2.3); MSM (HR 1.1; 95% CI 1.1 to 1.2) and IDU (HR 1.5; 95% CI 1.3 to 1.6) exposure categories; up to 8 years of schooling (HR 1.4; 95% CI 1.3 to 1.5) and no schooling (HR 2.1; 95% CI 1.6 to 2.8); and CD4 count between 350 and 500 cells/mm3 (HR 1.2; 95% CI 1.1 to 1.2) and <350 cells/mm3 (HR 1.3; 95% CI 1.2 to 1.3).

Conclusions Increase in AIDS survival and decrease in the mortality rates were observed with HAART. Predictor factors to death were AIDS diagnosis period, age, transmission categories, schooling and CD4 count. The results show the great positive impact of the Brazilian National AIDS Program.

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