Naslov
Marked improvement in survival following AIDS after introduction of highly active antiretroviral therapy (HAART) in adult patients from Croatia

Autori
Begovac, J ; Lisić, M: Skerlev, M

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
The XV International AIDS Conference / - , 2004

Skup
The XV International AIDS Conference

Mjesto i datum
Bangkok, Tajland, 11.07.2004. - 16.07.2004

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
AIDS; HAART

Sažetak
Background: Croatia is a South-Eastern European developing country with a low level HIV-epidemic and a centralized system of care for HIV/AIDS, so all patients are treated at one institution. The aim of this study was to compare the survival of patients after AIDS in the pre-HAART era 1986-1996 to the early HAART era 1997-2000. Methods: In this cohort study data were collected retrospectively up to 1998 and prospectively thereafter. Each patient was considered as a censored observation at the time of last contact if lost to follow-up or known to be alive on Dec 31, 2002. Survival times were calculated using the Kaplan-Meier (KM) method. Cox's proportional hazards model was used to examine factors associated with survival. Different survival periods were modeled, according to the log-minus-log survival plot, for the categories of CD4+ cell count and HAART era. Results: Of 144 patients (88 from pre-HAART and 56 from HAART era) 90 died ; 72 (81.8%) and 18 (32.1%) respectively. 17/88, 19.3%, and 48/56, 85.7%, of patients received HAART, respective to study eras. The 1- and 5-year survival probabilities in the pre-HAART era were 52.1% and 15.4% whereas in the HAART era they were 72.8% and 61.9% respectively. In multivariable analysis survival after 6 months was lower for patients in the HAART era (Hazard Ratio [HR] 0.11 ; 95% CI, 0.04-0.29, p<0.0001) compared to the pre-HAART era. A CD4+ cell count of < 100/mm3 was an independed risk factor for patients surviving up to 2 years (HR 2.14 ; 95% CI, 1.2-3.77, p=0.009), afterward it was not (HR 1.04, 95% CI 0.32-3.34, p=0.95). Patients with tuberculosis/fungal infections had a better survival when compared to other diagnosis (HR 0.46, 95% CI 0.27-0.77, p=0.003). PCP prophylaxis did not reach significance (HR ; 0.62 ; 95% CI 0.36-1.05, p=0.07). Conclusion: Survival after AIDS has markedly improved after introduction of HAART in Croatia. The 1-year probability of death after AIDS was still high in the early HAART era.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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