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
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).
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),
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%).
commonly prescribed nucleos(t)ides are: AZT/3TC (54.1%), 3TC (32.6%), abacavir
(20%), d4T (16.4%), tenofovir (10%).
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.
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
granted by Fogarty-AITRP Grant#5D43TW001037.
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