Effect of sociodemographic, clinical-prophylactic and therapeutic procedures on survival of AIDS patients assisted in a Brazilian outpatient clinic

Revista Brasileira de Epidemiologia

Dario José Hart Pontes Signorini²  Claudia Torres Codeço¹  Marilia Sá Carvalho¹  Dayse Pereira Campos¹  Michelle Carreira Miranda Monteiro²  Marion De Fátima Castro De Andrade²  Jorge Francisco Da Cunha Pinto²  Carlos Alberto Morais De Sá² 

[1] ,Universidade Federal do Estado do Rio de Janeiro Hospital Universitário Gaffrée e Guinle Rio de Janeiro

关键词: Epidemiological studies;    Cohort studies;    Proportional risk models;    Non-parametric methods;    Survival analysis;    Anti-HIV agents;    Fatal outcome;    Survival rate;    Hospital mortality;    Brazil;    Estudos epidemiológicos;    Estudos de coortes;    Modelos de riscos proporcionais;    Métodos não paramétricos;    Análise de sobrevivência;    Agentes anti-HIV;    Evolução fatal;    Taxa de sobrevivência;    Mortalidade hospitalar;    Brasil;   

DOI  :  10.1590/S1415-790X2005000300007

来源: SciELO

【 摘 要 】

The Brazilian AIDS Program offers free and universal access to antiretroviral therapy. This study investigates the influence of sociodemographic, clinical-prophylactic and therapeutic factors on survival, after AIDS diagnosis, in an open cohort of 1,420 patients assisted in a university hospital in the city of Rio de Janeiro (1995 _ 2002). Kaplan-Meier and Cox proportional hazards models were used to estimate the effect of variables in the three dimensions studied. The overall survival time of the upper quartile was 24 months (CI95%= 20.5-27.5), increasing from 14 months, in 1995, to 46 months, in 1998. We found a protective effect of heterosexual behavior against death that could be attributed to the increasing female-to-male sex ratio in the cohort, which coincided with the time of therapy introduction. Low schooling, hospital admission and lack of follow-up were identified as risk factors for death; PCP and Toxoplasmosis prophylaxis were protective. The number of attempts required to consolidate the antiretroviral therapy showed no significant effect on survival. The full model, which includes the number of antiretroviral drugs in the regimen, confirmed the triple therapy as the best regimen. This study brings important information for designing guidelines to deal with different aspects related to the practical management of patients and their behavior, thus contributing to the success of the program of free access to antiretroviral therapy implemented in Brazil.

【 授权许可】

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