Late disease clinical stage at starting HAART in the surrounding area of the city of Buenos Aires
E. Warley1, A. De Luca2, J. Desse2, G. Fernandez Galimberti2, G. D´agostino3, L. Quintas3, I. Vieni2, M. Salas2, E. Szyld4
1Hospital Dr Diego Paroissien - Hospital de Moron, Buenos Aires, Argentina, 2Hospital Dr Diego Paroissien, Buenos Aires, Argentina, 3Hospital de Moron, Buenos Aires, Argentina, 4FUNDASAMIN, Buenos Aires, Argentina
Background: In Argentina access to HIV treatment is free and widespread according to guidelines. Late disease clinical stage at starting HAART (LDCSH) is a challenge for treatment success.The aim of our study is to evaluate frequency and possible LDCSH-associated factors.
Methods: We analyzed clinical and epidemiological variables in a cross-sectional study of two hospital cohorts of HIV naive patients that started HAART between 2005-2009.Statistical analysis: Frequency distribution and descriptive statistics. Categorical variables were compared using chi square or Fisher´s exact test. Variables statistically associated at bivariate analysis were incorporated in a logistic regression model.
Results: We analyzed clinical charts of 264 patients, 123 women (46.6%) and 141 men (53.4%). Median age was 37.7 years. We observed LDCSH in 132 cases (50 %), out of wich 102 (77.2.8%) were late diagnosis and 30 (22%) were patients not engaged in care.Median CD4 count 120 cells/ml and of viral load 58038 cop/ml. The CD4 count was below 150 cells/ml in 144 patients (59.3%). The primary modes of transmission were heterosexual in 75 % of cases and intravenous drug use in 17,4%.Men presented more frequently LDCSH than women (59.8% vs 40.2%). Women were diagnosed during a pregnancy in 25.2% of cases.Male sex (p: 0.03) was statistically associated with LDCSH in both bivariate and multivariate analysis. Alcohol consumption (p:0.006), singlehood (p0.04) and no secondary education (p:0.008) were contributing factors only in the bivariate analysis .There were no associations with the other analyzed variables: primary mode of transmission, illegal drug use, unemployment and age higher than 45 years.
Conclusions: We observed one of the highest reported frequency of LDCSH in the study population. Our data reinforce the need to spread HIV testing and should assist to develop programmes promoting early entry into HIV care.
Partially supported by FIC/NIH (Grant # 5D43 TW001037-09).
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