ArticleAIDS research and therapy2014
Effectiveness of first-line antiretroviral therapy in the IPEC cohort, Rio de Janeiro, Brazil.
Article in AIDS research and therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- Viral load suppression among HIV-positive adult patients on the first-line antiretroviral treatment regimen in health facilities in the City of Ekurhuleni, Gauteng province, South Africa.The Pan African medical journal · 2024Article
- Real-world effectiveness of WHO recommended first-line antiretroviral therapies: a cohort study from a middle-income country.AIDS care · 2023Article
- Suppression of HIV in the first 12 months of antiretroviral therapy: a comparative analysis of dolutegravir- and efavirenz-based regimens.Einstein (Sao Paulo, Brazil) · 2023Article
- Multilevel Analysis of Individual and Neighborhood Characteristics Associated with Viral Suppression Among Adults with HIV in Rio de Janeiro, Brazil.AIDS and behavior · 2022Article
- Effectiveness of antiretroviral therapy in the single-tablet regimen era.Revista de saude publica · 2018Article
- Adverse reactions associated with first-line regimens in patient initiating antiretroviral therapy.European journal of clinical pharmacology · 2018Article
- Pharmacy refill data can be used to predict virologic failure for patients on antiretroviral therapy in Brazil.Journal of the International AIDS Society · 2017Article
- Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort.AIDS care · 2017Article
- Incidence and Predictors of Antiretroviral Treatment Modification in HIV-Infected Adults: A Brazilian Historical Cohort from 2001 to 2010.Journal of tropical medicine · 2017Article
- Retention in Early Care at an HIV Outpatient Clinic in Rio de Janeiro, Brazil, 2000-2013.AIDS and behavior · 2016Article
- Article
- Survival benefits of antiretroviral therapy in Brazil: a model-based analysis.Journal of the International AIDS Society · 2016Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundWhile Brazil has had a long-standing policy of free access to antiretroviral therapy (ART) for all in need, the epidemiological impact of ART on human immunodeficiency virus (HIV) RNA suppression in this middle-income country has not been well evaluated. We estimate first-line ART effectiveness in a large Brazilian cohort and examine the socio-demographic, behavioral, clinical and structural factors associated with virologic suppression.
methodsVirologic suppression on first-line ART at 6, 12, and 24 months from start of ART was defined as having a viral load measurement ≤400 copies/mL without drug class modification and/or discontinuation. Drug class modification and/or discontinuation were defined based on the class of a particular drug. Quasi-Poisson regression was used to quantify the association of factors with virologic suppression.
resultsFrom January 2000 through June 2010, 1311 patients started first-line ART; 987 (75%) patients used NNRTI-based regimens. Virologic suppression was achieved by 77%, 76% and 68% of patients at 6, 12 and 24 months, respectively. Factors associated with virologic suppression at 12 months were: >8 years of formal education (compared to <4 years, risk ratio (RR) 1.13, 95% confidence interval (95% CI) 1.03-1.24), starting ART in 2005-2010 (compared to 2000-2004, RR 1.25 95% CI 1.15-1.35), and clinical trial participation (compared to no participation, RR 1.08 95% CI 1.01-1.16). Also at 12 months, women showed less virologic suppression compared to heterosexual men (RR 0.90 95% CI 0.82-0.99). For the 24-month endpoint, in addition to higher education, starting ART in the later period, and clinical trial participation, older age and an NNRTI-based regimen were also independently associated with virologic suppression.
conclusionsOur results show that in Brazil, a middle-income country with free access to treatment, over three-quarters of patients receiving routine care reached virologic suppression on first-line ART by the end of the first year. Higher education, more recent ART initiation and clinical trial participation were associated with improved outcomes both for the 12-month and the 24-month endpoints, suggesting that further studies are needed to understand what aspects relating to these factors lead to higher virologic suppression.
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