Late-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors

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dc.contributor.authorNúñez, Isaac
dc.contributor.authorCrabtree-Ramirez, Brenda
dc.contributor.authorShepherd, Bryan E
dc.contributor.authorSterling, Timothy R
dc.contributor.authorCahn, Pedro
dc.contributor.authorVeloso, Valdiléa G
dc.contributor.authorCortes, Claudia
dc.contributor.authorPadgett, Denis
dc.contributor.authorGotuzzo, Eduardo
dc.contributor.authorSierra-Madero, Juan
dc.contributor.authorMcGowan, Catherine C
dc.contributor.authorPerson, Anna K
dc.contributor.authorCaro-Vega, Yanink
dc.date.accessioned2024-05-20T19:25:45Z
dc.date.available2024-05-20T19:25:45Z
dc.date.issued2022-09
dc.description.abstractObjectives: The aim of this study was to describe the incidence, clinical characteristics, and risk factors of late-onset opportunistic infections (LOI) in people who live with HIV (PWLHA) within the Caribbean, Central and South America network for HIV epidemiology. Methods: We performed a retrospective cohort study including treatment-naive PWLHA enrolled at seven sites (Argentina, Brazil, Chile, Peru, Mexico, and two sites in Honduras). Follow-up began at 6 months after treatment started. Outcomes were LOI, loss to follow-up, and death. We used a Cox proportional hazards model and a competing risks model to evaluate risk factors. Results: A total of 10,583 patients were included. Median follow up was at 5.4 years. LOI occurred in 895 (8.4%) patients. Median time to opportunistic infection was 2.1 years. The most common infections were tuberculosis (39%), esophageal candidiasis (10%), and Pneumocystis jirovecii (P. jirovecii) pneumonia (10%). Death occurred in 576 (5.4%) patients, and 3021 (28.5%) patients were lost to follow-up. A protease inhibitor-based regimen (hazard ratio 1.25), AIDS-defining events during the first 6 months of antiretroviral-treatment (hazard ratio 2.12), starting antiretroviral-treatment in earlier years (hazard ratio 1.52 for 2005 vs 2010), and treatment switch (hazard ratio 1.31) were associated with a higher risk of LOI. Conclusion: LOI occurred in nearly one in 10 patients. People with risk factors could benefit from closer follow-up.
dc.identifier.citationInt J Infect Dis . 2022 Sep:122:469-475. doi: 10.1016/j.ijid.2022.06.041.
dc.identifier.otherhttps://doi.org/10.1016/j.ijid.2022.06.041
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/981
dc.language.isoen
dc.publisherInternational Society for Infectious Diseases
dc.relation.ispartofseriesInternational Journal of Infectious Diseases; 122
dc.subjectAIDS
dc.subjectCohort studies
dc.subjectHIV
dc.subjectLatin America
dc.subjectOpportunistic infections
dc.titleLate-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors
dc.typeArticle

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