Survival of cases with AIDS, 13 years old and over, post-HAART, in two regions of Brazil
M.C. Alves1, I. Guibu2,3, M. Barros4, M.R. Donalisio4, A. Tayra2
1Seretaria de Estado da Saude de Sao Paulo, Instituto de Saude, Sao Paulo, Brazil, 2State Program of STD/AIDS, Sao Paulo, Brazil, 3Faculdade de Ciências Médicas da Santa Casa de São Paulo, Social Medicine Dept, Sao Paulo, Brazil, 4Faculdade de Ciências Médicas da UNICAMP, Medicina Preventiva, Campinas, Brazil
Background: Median survival of patients with AIDS, 13 years old or over, in Brazil, diagnosed in the 1982-1989 period was 5.1 months; in 1995 it was 16 months and in 1996, 58 months. As of 1996, HAART became available for all patients with AIDS. The study aimed to evaluate survival time of patients in this age group, diagnosed in 1998 and 1999, reported to the STD/AIDS Disease Surveillance, living in the South and Southeast that account for 80% of AIDS cases in the country.
Methods: Cohort study. The sample was comprised by patients with AIDS, over 12 years of age, diagnosed in 1998 and 1999. A stratified cluster sample was used. A questionnaire for collecting data from medical records was prepared. The survival time variable was created using date of diagnosis and date of death for patients who died, and date of diagnosis and date of last contact with the service for patients who survived. The Cox model was used for studying variables associated with survival.
Results: 2,091 cases were analyzed. Median survival of 9 years of observation was not reached, because 59.4% of patients survived 108 months. The main characteristic related with the increase in survival were: being female, having better schooling, being white, having used antiretroviral medication, having been classified as AIDS case early through CD4 count, having had sexual exposure and not injecting drug use, not having had tuberculosis or hepatitis B, and having been seen at services with multiprofessional teams.
Conclusion: There was a substantial increase in survival of patients with Aids based on previous studies, mainly due to earlier diagnosis and to ART.
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