4th International AIDS Society Conference on HIV Pathogenesis and Treatment Sydney, Australia - July 22 - 25, 2007

GENDER-BASED DIFFERENCES IN HIV TREATMENT AND OUTCOME AMONG PATIENTS RECEIVING GENERIC HAART IN SOUTH INDIA

IAS Conf HIV Pathog Treat 2007 Jul 22-25;4th: Abstract No. MOPDB03

Kumarasamy N.¹, Venkatesh K², Cecelia A.¹, Devaleenal B.¹, Saghayam S.¹, Yepthomi T.¹, Balakrishnan P.¹, Flanigan T.², Solomon S.¹, Mayer K.^2
1YRGCARE,VHS, Chennai, India, ²Brown University, Providence, United States

OBJECTIVES: To describe gender-based differences in disease progression, treatment, and outcome among patients receiving generic HAART in South India.

METHODS: YRG Center for AIDS Research an Education (YRG CARE) in Chennai is a non-profit HIV tertiary care centre in India providing medical care for over 10,000 HIV-infected individuals since 1996. This is study was conducted using the YRG CARE Chennai HIV observational Database. Patients who were >18 years of age, naïve to ART before initiation of HAART and with atleast one-year follow up on therapy were included in the analysis. c² statistics and Mann-Whitney U test were used to assess the statistical significance of p<0.05.

RESULTS: A total of 2,864 antiretroviral therapy naïve patients who initiated HAART were analyzed. At enrollment, women were more likely to report with higher CD4 levels (141 vs. 114 cells/mL), total lymphocyte count (1400 vs. 1301), BMI (19.4 vs. 18.7 kg/m²); and lower hemoglobin (10.5 vs. 11.3 g/dl) than their male counterparts (p<0.05). At the time of initiating therapy, women continued to present with higher CD4 levels and lower hemoglobin relative to men (p<0.05). The difference in CD4 levels between men and women failed to be significant in the year after initiating therapy. During the course of HAART, more women developed Herpes simplex lesions (8.5 vs. 4.4%) and more men developed extra pulmonary tuberculosis (10.3 vs. 4.9%, p<0.05). Significantly more men experienced immune reconstitution syndrome (6 vs. 2%), while significantly more women developed lactic acidosis (2.8 vs. 0.7%, p<0.05). Women reported higher follow-up period and significantly lower rates of death than men (p<0.05).

CONCLUSION: Significant physiologic, immunologic, and clinical differences exist between men and women initiating HAART in a resource poor clinical setting in South India. However, immunologic gender-based differences diminish over time after initiating HAART.

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2007-07-22
MOPDB03
Pathogenesis and Treatment in Women

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