ArticleBMC public health2015
Improvement of HAART in Brazil, 1998-2008: a nationwide assessment of survival times after AIDS diagnosis among men who have sex with men.
Article in BMC public health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- A New Start with HAART: Evaluating Breast Reconstruction in the Era of Highly Active Antiretroviral Therapy.Plastic and reconstructive surgery. Global open · 2024Article
- Dynamics and features of transmission clusters of HIV-1 subtypes in the state of São Paulo, Brazil.Frontiers in public health · 2024Article
- Mortality and survival of tuberculosis coinfected patients living with AIDS in São Paulo, Brazil: a 12-year cohort study.BMC infectious diseases · 2022Article
- A novel Bursin-like peptide as a potential virus inhibitor and immunity regulator in SPF chickens infected with recombinant ALV.BMC veterinary research · 2019Article
- Triad of the Ischemic Cardiovascular Disease in People Living with HIV? Association Between Risk Factors, HIV Infection, and Use of Antiretroviral Therapy.Current atherosclerosis reports · 2018Review
- HIV prevalence and sexual behavior among young male conscripts in the Brazilian army, 2016.Medicine · 2018Article
- Human Immunodeficiency Virus Infection, Antiretroviral Therapy, and Statin: a Clinical Update.Current atherosclerosis reports · 2018Review
- [Survival analysis in people diagnosed with HIV/AIDS in Puerto Rico].Revista Puertorriquena de medicina y salud publica · 2018Article
- Low bone mineral density among HIV-infected patients in Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2017Article
- Pharmacogenomics Implications of Using Herbal Medicinal Plants on African Populations in Health Transition.Pharmaceuticals (Basel, Switzerland) · 2015Article
- High HIV infection prevalence in a group of men who have sex with men.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundIn 1996, Brazil became the first developing country to provide free, universal access to HAART, laboratory monitoring, and clinical care to any eligible patient. As of June 2014, approximately 400,000 patients were under treatment, making it the most comprehensive HIV treatment initiative implemented thus far in a middle-income country, worldwide. The Brazilian epidemic is highly concentrated among men who have sex with men (MSM).
methodsFour national information systems were combined and Cox regression was used to conduct retrospective cohort analysis of HAART availability/access on all-cause mortality among MSM diagnosed with AIDS reported to the information systems between 1998-2008, adjusting for demographic, clinical, and behavioral factors and controlling for spatially-correlated survival data by including a frailty effect. Multiple imputation by chained equations was used to handle missing data.
resultsAmong 50,683 patients, 10,326 died during the 10 year of period. All-cause mortality rates declined following introduction of HAART, and were higher among non-white patients and those starting HAART with higher viral load and lower CD4 counts. In multivariable analysis adjusted for race, age at AIDS diagnosis, and baseline CD4 cell count, MSM diagnosed in latter periods had almost a 50% reduction in the risk of death, compared to those diagnosed between 1998-2001 (2002-2005 adjHR: 0.54, 95% CI:0.51-0.57; 2006-2008 adjHR: 0.51, 95% CI:0.48-0.55). After controlling for spatially correlated survival data, mortality remained higher among those diagnosed in the earliest diagnostic cohort and lower among non-white patients and those starting HAART with higher viral load and lower CD4 lymphocyte counts.
conclusionsUniversal and free access to HAART has helped achieve impressive declines in AIDS mortality in Brazil. However, after a 10-years follow-up, differential AIDS-related mortality continue to exist. Efforts are needed to identify and eliminate these health disparities, therefore improving the Brazilian response towards HIV/AIDS epidemic.
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