Gender differences in the long-term effectiveness of antiretroviral therapy among perinatally HIV-1 infected children and adolescents
E. Souza1,2, S. Valentini3, N. Santos2, G. Silva4, J. Figueiroa4, A. Falbo4
1Instituto de Medicina Integral Prof. Fernando Figueira, Research Department, Recife, Brazil, 2Faculdade Pernambucana de Saúde, Recife, Brazil, 3Faculdade Pernambucana de Saúde, Medicina, Recife, Brazil, 4Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil
Background: Highly active antiretroviral therapy (HAART) is considered the main factor behind the improvement of survival rates among HIV-infected children and adolescents. The aim of this study was to evaluate the effectiveness and durability of highly active antiretroviral therapy (HAART) in perinatally HIV-1 infected children and adolescent according to gender.
Methods: We studied a total of 195 children and adolescents with perinatally acquired HIV infection enrolled at a historical cohort study at IMIP´s AIDS clinic, leading paediatric HIV centre in a tertiary health care hospital in Recife, Pernambuco State, Brazil, from 1987 to 2008. The main outcome measure was response to antiretroviral therapy and its durability. Statistical analysis was done by survival analysis.
Results: At the end of the follow-up, 102 (52.3%) had successful response to HAART with a mean time of any HAART use of 4.9 (SD, 2,5; min. 0.7, max. 9.9) years. After adjustment for baseline and HAART factors, success treatment outcome was inversely associated with male gender (odds ratio, OR = 0.5, p = .029). Additionally, the time to failure of 1st HAART was negatively associated with male gender (relative hazard, RH=0,5, p = .021). Figure 1 shows survival probability, i.e. time to antiretroviral failure, according to gender.
Conclusions: HAART effectiveness and durable response was associated with female gender.
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