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14th International AIDS ConferenceBarcelona, Spain - July 7-12, 2002 |
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10727)
Campos DP, Gadelha AM, Veloso VG, Grinsztejn BG, Ribeiro SR, Bandeira TS, Valente JG
Center of Research Hospital Evandro Chagas - FIOCRUZ., Rio de Janeiro, Brazil
BACKGROUND: The Brazilian policy of universal access to antiretroviral therapy (ARVT) is resulting in a significant decrease of AIDS related deaths. To determine AIDS patients survival and related factors, a survival analysis was conducted in a Research Center
METHODS: Of 1591 HIV+ individuals registered between 1986-99, a representative sample of 392 individuals was selected, with 193 aids cases defined (CDC93). The survival was considered as the elapsed time of the date of AIDS diagnosis until death, censorship defined for the patients with loss of follow up or that stayed alive until December of 2000 with date of the censorship as the one of the last attendance. Kaplan-Meier analysis and Cox Model were performed
RESULTS: The general median survival was 41 months. The survival function for men was significantly lower (p<0,05) than for the females, but when adjusted for use of ARVT or for the year of AIDS diagnosis, the differences observed were not significant. Around 84% of the patients who had AIDS diagnosis defined after 1996 survived for more than 36 months while among the cases defined until 1990 only 50% of the patients survived more than 29 months. Lack of ARVT, lack of PCP prophylaxis, esophageal candidiasis diagnosis, AIDS defined by two illnesses and at least one hospitalization were significant for the survival reduction in the model. Patients who had no access to ARVT presented a hazard ratio (HR) 20 times greater to survive less time compared to those who used HAART, independently of other factors. However, when controlled by the other variables of the adjusted Cox model the HR was reduced to 11
CONCLUSIONS: A relatively high overall survival rate was observed. Antiretroviral therapy and PCP prophylaxis were significantly associated with a greater survival prediction. This can be partially explained by the fact that all the cases surveyed were originated from a research hospital and by the access free of charge to the prescribed medicines
020707
C10727
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