학술논문

Clinical and Immunologic Outcomes of HAART-Treated HIV-Infected Women in Resource Constrain Settings: The Belgrade Study.
Document Type
Journal Article
Source
Women & Health. Jan2014, Vol. 54 Issue 1, p35-47. 13p.
Subject
*EVALUATION of medical care
*CHI-squared test
*CONFIDENCE intervals
*EPIDEMIOLOGY
*FISHER exact test
*HIV infections
*LONGITUDINAL method
*MULTIVARIATE analysis
*RESEARCH funding
*T cells
*WOMEN
*DATA analysis
*SOCIOECONOMIC factors
*HIGHLY active antiretroviral therapy
*RETROSPECTIVE studies
*DATA analysis software
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*LOG-rank test
Language
ISSN
0363-0242
Abstract
We performed a study to identify factors related to favorable response to highly active-antiretroviral therapy (HAART) in HIV-infected women. A retrospective study was performed on 216 women who had initiated HAART from January 1, 1998 to December 31, 2012, at the HIV/AIDS Center, Belgrade, Serbia. Participants were followed-up for 8.2 ± 3.4 years. The mean age was 37 ± 9.7 years. During follow-up, it was found that 26 patients had died. Clinical AIDS at initiation of HAART was observed in 43.9% patients, while 64.8% had a CD4+ T-cell count below 200 cells/μL. Multivariate analyses revealed that the single factor independently related to a favorable response to HAART was good compliance (odds [OR] ratio for survival = 2.9, 95% confidence intervals [CI] = 1.0–8.6, p = 0.03), while a baseline CD4+ T-cell count below 100 cells/μL, hepatitis C virus coinfection, and aged 40 years and older were all associated with an unfavorable response to HAART (OR = 0.28, 95% CI = 0.15–0.52, p < 0.001; OR = 0.49, 95% CI = 0.22–0.8, p = 0.008; OR = 0.41, 95% CI = 0.21–0.79, p = 0.008, respectively). The estimated 14-year-survival was 100% in patients with sustained viral suppression, regardless of the CD4+ counts achieved (p = 0.6, log-rank). If women with advanced HIV-related immunodeficiency reach and maintain optimal viral suppression during HAART, regardless of the level of immune recovery, and if they continue to maintain this suppression for up to a mean 8 years of treatment, their prognosis may be fairly good, even in resource-limited settings. [ABSTRACT FROM AUTHOR]