16th International AIDS Conference Toronto, Canada - August 13 - 18, 2006

OUTCOMES OF HAART IN HIV-1 INFECTED INDIVIDUALS IN BUENOS AIRES, ARGENTINA

Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. ThAb0203

Zala C.¹, Hogg R.², Salomon H.³, Chan K.², Ceriotto M.⁴, Beltran M.⁵, Burgos M.⁶, Montaner J.S.², Cahn P.¹, and the PUMA study team
¹ Htal Fernandez, BA, Argentina, ² Center for Excellence in HIV/AIDS, Vancouver, Canada, ³ CNRS, University of Buenos Aires, Buenos Aires, Argentina, ⁴ Htal Cecilia Grierson, BA, Argentina, ⁵ Htal Central de San Isidro, BA, Argentina, ⁶ Htal Tornu, BA, Argentina

BACKGROUND: Despite free access to ARVs, limited data on outcomes of HIV-infected individuals who initiate HAART are available from Argentina.

OBJECTIVES: To evaluate plasma HIV-1 RNA (pVL), and CD4 among ARV-naïve HIV-positive subjects seeking for HAART.

METHODS: An ongoing multi-site based cohort at public HIV clinics. Between Jan 2003 and Dec 2005, consecutive HIV-1 infected individuals were prospectively followed. Primary endpoints were CD4 and pVL response. Two separate Cox-proportional hazard regression models were constructed to fit simultaneous effect on prognostic variables on the outcomes of CD4 and pVL response.

RESULTS: A total of 605 participants (170 females) entered the program, of whom, 299 (49 %) initiated HAART. Median f/u was 17.8 months (IQR: 6 – 6 – 26.4). Baseline CD4 and pVL was 223 cells/mm³ (IQR: 75 – 431) and 48,116 copies/mL (5,523 – 200,153) respectively. 184 (62 %) initiated with NNRTIs and 105 (35%) initiated with PIs. A total of 85 (14 %) subjects were lost to follow-up. Those who started therapy were more likely to be older, to have AIDS (35 % vs. 12 %; p<0.001) and lower CD4 (median 105 vs. 337; p< 0.001) Of the 205 participants with ≥ 2 pVL measurements, 172 (84%) and 78 (38%) achieved at least one <500 and <50 copies/mL respectively. Participants with higher pVL at BSL and not taking NNRTI were less likely to reach 2 consecutive pVL <50 copies/mL. Of the 272 participants with ≥2 CD4 measurements, 49 % achieved an increase of ≥100 cells over BSL. Ten (2%) patients died during the observational period.

CONCLUSIONS: We report data on the effect of HAART within a population-based cohort in Argentina. Initiation of HAART was associated with an advanced HIV disease. Urgent efforts are needed to optimize timing of initiation of antiretroviral therapy in our setting.

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2006-08-13
ThAb0203

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