Effect of sociodemographic, clinical-prophylactic and therapeutic procedures on survival of AIDS patients assisted in a Brazilian outpatient clinic
Rev. bras. epidemiol
;
8(3): 253-261, set. 2005. tab
Article
in English
| LILACS
| ID: lil-416015
RESUMO
The Brazilian AIDS Program offers free and universal access to antiretroviral therapy. This study investigates the influence of sociodemographic, clinical-prophylactic and therapeutic factors on survival, after AIDS diagnosis, in an open cohort of 1,420 patients assisted in a university hospital in the city of Rio de Janeiro (1995 _ 2002). Kaplan-Meier and Cox proportional hazards models were used to estimate the effect of variables in the three dimensions studied. The overall survival time of the upper quartile was 24 months (CI95 percent= 20.5-27.5), increasing from 14 months, in 1995, to 46 months, in 1998. We found a protective effect of heterosexual behavior against death that could be attributed to the increasing female-to-male sex ratio in the cohort, which coincided with the time of therapy introduction. Low schooling, hospital admission and lack of follow-up were identified as risk factors for death; PCP and Toxoplasmosis prophylaxis were protective. The number of attempts required to consolidate the antiretroviral therapy showed no significant effect on survival. The full model, which includes the number of antiretroviral drugs in the regimen, confirmed the triple therapy as the best regimen. This study brings important information for designing guidelines to deal with different aspects related to the practical management of patients and their behavior, thus contributing to the success of the program of free access to antiretroviral therapy implemented in Brazil.
Full text:
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Index:
LILACS (Americas)
Main subject:
Epidemiologic Studies
/
Proportional Hazards Models
/
Survival Analysis
/
Cohort Studies
/
Data Interpretation, Statistical
/
Hospital Mortality
/
Fatal Outcome
/
Anti-HIV Agents
Type of study:
Etiology study
/
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. bras. epidemiol
Journal subject:
Epidemiology
/
Public Health
Year:
2005
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Oswaldo Cruz/BR
/
Universidade Federal do Estado do Rio de Janeiro/BR
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