Cross-Sectional Analysis of Late HAART Initiation in Latin America and the Caribbean: Late Testers and Late Presenters

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dc.contributor.authorCrabtree-Ramirez, Brenda
dc.contributor.authorCaro-Vega, Yanink
dc.contributor.authorShepherd, Bryan E.
dc.contributor.authorWehbe, Fernando
dc.contributor.authorCesar, Carina
dc.contributor.authorPadgett, Denis
dc.contributor.authorKoenig, Serena
dc.contributor.authorGotuzzo, Eduardo
dc.contributor.authorCahn, Pedro
dc.contributor.authorMcGowan, Catherine C.
dc.contributor.authorMasys, Daniel R.
dc.contributor.authorSierra Madero, Juan
dc.contributor.authorCortes, Claudia
dc.date.accessioned2024-05-23T18:53:33Z
dc.date.available2024-05-23T18:53:33Z
dc.date.issued2011
dc.description.abstractBackground: Starting HAART in a very advanced stage of disease is assumed to be the most prevalent form of initiation in HIV-infected subjects in developing countries. Data from Latin America and the Caribbean is still lacking. Our main objective was to determine the frequency, risk factors and trends in time for being late HAART initiator (LHI) in this region. Methodology: Cross-sectional analysis from 9817 HIV-infected treatment-naïve patients initiating HAART at 6 sites (Argentina, Chile, Haiti, Honduras, Peru and Mexico) from October 1999 to July 2010. LHI had CD4(+) count ≤200 cells/mm(3) prior to HAART. Late testers (LT) were those LHI who initiated HAART within 6 months of HIV diagnosis. Late presenters (LP) initiated after 6 months of diagnosis. Prevalence, risk factors and trends over time were analyzed. Principal findings: Among subjects starting HAART (n = 9817) who had baseline CD4(+) available (n = 8515), 76% were LHI: Argentina (56%[95%CI:52-59]), Chile (80%[95%CI:77-82]), Haiti (76%[95%CI:74-77]), Honduras (91%[95%CI:87-94]), Mexico (79%[95%CI:75-83]), Peru (86%[95%CI:84-88]). The proportion of LHI statistically changed over time (except in Honduras) (p≤0.02; Honduras p = 0.7), with a tendency towards lower rates in recent years. Males had increased risk of LHI in Chile, Haiti, Peru, and in the combined site analyses (CSA). Older patients were more likely LHI in Argentina and Peru (OR 1.21 per +10-year of age, 95%CI:1.02-1.45; OR 1.20, 95%CI:1.02-1.43; respectively), but not in CSA (OR 1.07, 95%CI:0.94-1.21). Higher education was associated with decreased risk for LHI in Chile (OR 0.92 per +1-year of education, 95%CI:0.87-0.98) (similar trends in Mexico, Peru, and CSA). LHI with date of HIV-diagnosis available, 55% were LT and 45% LP. Conclusion: LHI was highly prevalent in CCASAnet sites, mostly due to LT; the main risk factors associated were being male and older age. Earlier HIV-diagnosis and earlier treatment initiation are needed to maximize benefits from HAART in the region.
dc.identifier.citationCrabtree-Ramirez, B., Caro-Vega, Y., Shepherd, B. E., Wehbe, F., Cesar, C., Padgett, D., ... Cortes, C. P. (2011). Cross-sectional analysis of late HAART initiation in Latin America and the Caribbean: Late testers and late presenters. PLoS ONE.
dc.identifier.otherDOI: 10.1371/journal.pone.0020272
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1101
dc.relation.ispartofseriesPLoS ONE
dc.subjectLate HAART Initiation
dc.subjectLatin America
dc.subjectCaribbean
dc.subjectLate Testers
dc.subjectLate Presenters
dc.titleCross-Sectional Analysis of Late HAART Initiation in Latin America and the Caribbean: Late Testers and Late Presenters

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