Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America

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dc.contributor.authorCesar, Carina
dc.contributor.authorKoethe, John R
dc.contributor.authorGiganti, Mark J
dc.contributor.authorRebeiro, Peter
dc.contributor.authorAlthoff, Keri N
dc.contributor.authorNapravnik, Sonia
dc.contributor.authorMayor, Angel
dc.contributor.authorGrinsztejn, Beatriz
dc.contributor.authorWolff, Marcelo
dc.contributor.authorPadgett, Denis
dc.contributor.authorSierra-Madero, Juan
dc.contributor.authorGotuzzo, Eduardo
dc.contributor.authorSterling, Timothy R
dc.contributor.authorWillig, James
dc.contributor.authorLevison, Julie
dc.contributor.authorKitahata, Mari
dc.contributor.authorRodriguez-Barradas, Maria C
dc.contributor.authorMoore, Richard D
dc.contributor.authorMcGowan, Catherine
dc.contributor.authorBryan E, Shepherd
dc.contributor.authorCahn, Pedro
dc.contributor.authorfor the Caribbean, Central and South America Network for HIV epidemiology (CCASAnet) and the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
dc.date.accessioned2024-05-23T23:49:10Z
dc.date.available2024-05-23T23:49:10Z
dc.date.issued2016-03-18
dc.descriptionFil: Cahn P. Fundación Huésped, Buenos Aires; Argentinaes_ES
dc.description.abstractIntroduction Latinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America. Methods HIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts. Results The study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57). Conclusions HIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation.es_ES
dc.formatapplication/pdfes_ES
dc.identifier.doihttps://doi.org/10.7448/ias.19.1.20684
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1320
dc.languageENGes_ES
dc.provenancePublishedes_ES
dc.relation.ispartofseriesJournal of the International AIDS Society;2016 Mar 18;19(1):20684
dc.rightsopenAccesses_ES
dc.subjectHIVes_ES
dc.subjectHispanic or Latinoes_ES
dc.subjectAntiretroviral Therapy, Highly Activees_ES
dc.titleHealth outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South Americaes_ES
dc.typeArticuloes_ES

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