XVIII International AIDS Conference

Abstract

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Patterns of antiretroviral prescription in the context of Argentina´s national AIDS and STIs programme

E. Bissio, C. Balleri, C. Falistocco, V. Curras, C. Bloch

Ministry of Health, Buenos Aires, Argentina

Background: In Argentina, The Ministry of Health provides care and treatment free of charge for aproximately 70% of HIV-patients (the rest served by HMOs/private insurances). The antiretroviral regimens are chosen by different physicians working at different hospitals throughout the country. Our aim was to analyze the patterns of prescription of the antiretroviral regimens provided by the Ministry of Health in Argentina and the characteristics of the patients receiving them.
Methods: Cross-sectional, descriptive study. The official database of antiretroviral drugs was utilized for the analysis. The database is made of data provided by the hospitals´ pharmacies (where antiretrovirals are dispensed).
Results: The list comprises 18943 patients, though the estimated number of patients receiving antiretrovirals from the Ministry of Health is 29000. Mean age (±SD) was 40.03 (11.43) years; 4.9% of the patients were < 16 years old, 15.3% older than 50. Forty percent were female. Hospitals in Buenos Aires city provide 37.4% of all treatments, and those from Buenos Aires province (excluding the city), 29.3% (together=66.7%).
Regarding the regimens, 58.7% of the patients are on non-nucleoside based regimens (efavirenz: 39.8%; nevirapine: 18.3%), 34.4% are on protease-inhibitor based regimens (lopinavir/r: 12.4%; atazanavir: 6.6%; saquinavir: 4.6%; indinavir: 4.2%; nelfinavir: 3.7%, fosamprenavir: 2.5%; darunavir: 0.2%; tipranavir: 0%).
The most commonly prescribed nucleos(t)ides are: AZT/3TC (54.1%), 3TC (32.6%), abacavir (20%), d4T (16.4%), tenofovir (10%).
The most frequent regimens are: AZT/3TC/efavirenz (24.3%), AZT/3TC/nevirapine (12%), abacavir/3TC/efavirenz (4.75%), AZT/3TC/LPV/r (3.8%), AZT/3TC/indinavir (1.94%), AZT/3TC/nelfinavir (1.64%), AZT/3TC/atazanavir (1.6%). Since the Ministry of Health started providing antiretrovirals, mortality rate due to AIDS in Argentina decreased: from 59.6/millon in 1996 to 36.0/millon in 2008.
Conclusions: The most common prescription patterns in Argentina are adjusted to the International guidelines; nevertheless, there is a high percentage of use of “older drugs”. We will next examine regional prescription patterns and trends in utilization.
Partially granted by Fogarty-AITRP Grant#5D43TW001037.


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