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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Predictors of progression to AIDS after HIV infection diagnosis in the pre- and post-HAART eras in a brazilian AIDS-free cohort
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Predictors of progression to AIDS after HIV infection diagnosis in the pre- and post-HAART eras in a brazilian AIDS-free cohort

机译：在巴西无艾滋病人群中，在HAART之前和之后的艾滋病毒感染诊断后，艾滋病的发展预测指标

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Background: The impact of HAART (highly active antiretroviral therapy) on the time for progression from HIV diagnosis to AIDS (TPHA) has been little studied in middle-income countries. This study aimed to analyze the TPHA in the pre- and post-HAART eras and to investigate its predictors. Method: We carried out a retrospective cohort study, including 1879 AIDS-free HIV-infected individuals diagnosed between 1988 and 2003 and followed up until 2005. The incidences of AIDS were estimated in person-years. The Kaplan-Meier method was applied to estimate TPHA and the Cox proportional hazard model used to assess predictors of TPHA. Results: AIDS incidence decreased from 12.8 to 5.0 per 1000 person-years over the period 1992 to 2003. TPHA (cumulative probability of AIDS-free time) for the maximum follow-up of 9 years was 21.9% among untreated individuals and 76.8% among those on HAART. Predictors of shorter TPHA included non-HAART ART treatment; no treatment; age ≥50 years; black/brown skin color; injection drug use; no schooling; and baseline CD4 lower than 500 cells/mm3. Conclusion: HAART has decreased AIDS incidence, prolonged life and increased the number of people living with HIV/AIDS. The post-HAART era presents new challenges to healthcare services in middle-income countries, the main requirements being enhanced strategies focused on early diagnosis, more resource allocation and developing approaches for healthcare systems to manage AIDS as a chronic disease.
机译：背景：在中等收入国家，很少研究HAART（高效抗逆转录病毒疗法）对从HIV诊断到AIDS（TPHA）病程发展的影响。这项研究旨在分析HAART之前和之后的TPHA，并研究其预测因素。方法：我们进行了一项回顾性队列研究，包括在1988年至2003年之间确诊并随访至2005年的1879名无艾滋病病毒感染者，其随访时间以人年为单位。应用Kaplan-Meier方法估计TPHA，使用Cox比例风险模型评估TPHA的预测因子。结果：在1992年至2003年期间，艾滋病的发病率从每1千人年12.8下降到5.0。未接受治疗的个体中，最长随访9年的TPHA（无艾滋病时间的累积概率）为21.9％，其中76.8％ HAART上的那些。 TPHA缩短的预测因素包括非HAART ART治疗。没有治疗;年龄≥50岁;黑/棕肤色;注射毒品没有上学;和基线CD4低于500细胞/ mm3。结论：HAART降低了艾滋病的发病率，延长了寿命，并增加了艾滋病毒/艾滋病感染者的数量。 HAART后时代对中等收入国家的医疗服务提出了新的挑战，主要要求是针对早期诊断，更多资源分配以及开发用于管理艾滋病作为慢性病的医疗系统的方法的增强策略。

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