Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional

Background: Chile, a middle-income country with an HIV epidemic of moderate proportions (global infection rate 0.2%) began a government sponsored, free, highly active antiretroviral therapy (HAART) for patients from the public health system in 2001 reaching in 2004 a 100% coverage. Arriaran Foundati...

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Autores principales:	Wolff R,Marcelo, Alvarez P,Patricia, Flores S,Ingrid, Northland A,Rebeca, Wolff L,Claudia
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2006
Materias:	Acquired immunodeficiency syndrome Antiretroviral therapy, highly active HIV seropositivity
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500006
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spelling	oai:scielo:S0034-988720060005000062006-06-22Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesionalWolff R,MarceloAlvarez P,PatriciaFlores S,IngridNorthland A,RebecaWolff L,Claudia Acquired immunodeficiency syndrome Antiretroviral therapy, highly active HIV seropositivity Background: Chile, a middle-income country with an HIV epidemic of moderate proportions (global infection rate 0.2%) began a government sponsored, free, highly active antiretroviral therapy (HAART) for patients from the public health system in 2001 reaching in 2004 a 100% coverage. Arriaran Foundation (AF) is the largest public AIDS care center for adults in the country. Aim: To show the present status of the AF population and the evolution of mortality. Material and Methods: Review of AF database from 1991-2004 that at 12/31/2004 had a total cumulative population of 2,259 adult patients; an active census of 1,065 patients and admitting rate 160-190 patients per years. Results: The global mortality registered was 33.4%, with decreasing annual mortality from 15.7% of its active population in 1995 to 1.9% in 2004. As of 12/31/2004, 817 patients (76.7%) were receiving antiretroviral therapy (ART); and 19.3% either did not require nor accept it. Thirty one percent received Combivir® and nevirapine, with undetectable viral load (<400 copies per ml) in 78%. Thirty percent received Combivir® and efavirenz with undetectable viral load in 80% at last count. Both regimens were used mainly as first therapy. Lopinavir/ritonavir was received by 6.3% of patients, mainly for post failure therapy and 58% had undetectable viral load. A baseline CD4 count <200 x mm³ was present in 70% of patients, 45.3% had a count below 100 and 47.8% had clinical AIDS. At the last follow up assessment, CD4 count was <200 in 36.8%, <100 in 10.6% and 200-350 in 44.9%. Conclusion: The expanded access program to ART in a public, comprehensive AIDS care center in Chile has been highly successful in reaching high undetectability (75%), reducing mortality and improving immune status despite very advanced baseline diseaseinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.134 n.5 20062006-05-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500006es10.4067/S0034-98872006000500006
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acquired immunodeficiency syndrome Antiretroviral therapy, highly active HIV seropositivity
spellingShingle	Acquired immunodeficiency syndrome Antiretroviral therapy, highly active HIV seropositivity Wolff R,Marcelo Alvarez P,Patricia Flores S,Ingrid Northland A,Rebeca Wolff L,Claudia Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional
description	Background: Chile, a middle-income country with an HIV epidemic of moderate proportions (global infection rate 0.2%) began a government sponsored, free, highly active antiretroviral therapy (HAART) for patients from the public health system in 2001 reaching in 2004 a 100% coverage. Arriaran Foundation (AF) is the largest public AIDS care center for adults in the country. Aim: To show the present status of the AF population and the evolution of mortality. Material and Methods: Review of AF database from 1991-2004 that at 12/31/2004 had a total cumulative population of 2,259 adult patients; an active census of 1,065 patients and admitting rate 160-190 patients per years. Results: The global mortality registered was 33.4%, with decreasing annual mortality from 15.7% of its active population in 1995 to 1.9% in 2004. As of 12/31/2004, 817 patients (76.7%) were receiving antiretroviral therapy (ART); and 19.3% either did not require nor accept it. Thirty one percent received Combivir® and nevirapine, with undetectable viral load (<400 copies per ml) in 78%. Thirty percent received Combivir® and efavirenz with undetectable viral load in 80% at last count. Both regimens were used mainly as first therapy. Lopinavir/ritonavir was received by 6.3% of patients, mainly for post failure therapy and 58% had undetectable viral load. A baseline CD4 count <200 x mm³ was present in 70% of patients, 45.3% had a count below 100 and 47.8% had clinical AIDS. At the last follow up assessment, CD4 count was <200 in 36.8%, <100 in 10.6% and 200-350 in 44.9%. Conclusion: The expanded access program to ART in a public, comprehensive AIDS care center in Chile has been highly successful in reaching high undetectability (75%), reducing mortality and improving immune status despite very advanced baseline disease
author	Wolff R,Marcelo Alvarez P,Patricia Flores S,Ingrid Northland A,Rebeca Wolff L,Claudia
author_facet	Wolff R,Marcelo Alvarez P,Patricia Flores S,Ingrid Northland A,Rebeca Wolff L,Claudia
author_sort	Wolff R,Marcelo
title	Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional
title_short	Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional
title_full	Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional
title_fullStr	Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional
title_full_unstemmed	Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional
title_sort	evolución de mortalidad y estado actual de una población infectada por vih controlada en un centro multiprofesional
publisher	Sociedad Médica de Santiago
publishDate	2006
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872006000500006
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Evolución de mortalidad y estado actual de una población infectada por VIH controlada en un centro multiprofesional

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