Response to Combined Antiretroviral Therapy According to Gender and Origin in a Cohort of Naive HIV-Infected Patients: GESIDA-5808 Study
Por:
Perez-Molina, JA, Rillo, MM, Suarez-Lozano, I, Casado-Osorio, JL, Cobo, RT, Gonzalez, PR, Clotet, EP, Hernando-Jerez, A, Domingo, P, Diaz, EB, Esteban, H, Gonzalez-Garcia, J
Publicada:
1 may 2012
Resumen:
Background: We analyzed differences in response to combined antiretroviral therapy (cART) according to sex and geographic origin in a retrospective comparative study of Spanish-born and immigrant patients initiating cART. Methods: The primary endpoint was time to treatment failure (TTF), defined as virological failure, death, opportunistic infection, interruption of cART, or loss to follow-up. Late diagnosis was defined as a CD4+ cell count <= 200 cells/mm(3) and/or AIDS at initiation of cART. Survival was analyzed using Kaplan-Meier analysis and Cox regression. Results: We followed 1,090 patients, of whom 318 were women (45.6% immigrant women [IW]). At initiation of treatment, women had a higher CD4+ count than men (217 vs 190 cells/mm(3)), a lower viral load (4.7 vs 5 log), and fewer were late starters (49% vs 59%). The adjusted risk of TTF between women and men was not significantly different (hazard ratio [HR], 1.10; 95% CI, 0.79-1.53). TTF was shorter among IW than Spanish-born women (124 weeks [95% CI, 64-183] vs 151 [95% Cl, 127-174]) and loss to follow-up was double that of Spanish-born women (25.5% vs 11.6%). Conclusions: Although response to cART was similar for both sexes, men started treatment later. IW were more frequently lost to follow-up and switched treatment. Measures to improve medical follow-up after initiation of cART should be promoted among this minority group.
Filiaciones:
Perez-Molina, JA:
Hosp Univ Ramon y Cajal IRYCIS, Dept Infect Dis, Madrid, Spain
Rillo, MM:
Hosp Univ La Paz, Dept Internal Med, Madrid, Spain
Suarez-Lozano, I:
Spanish VACH Cohort, Huelva, Spain
Casado-Osorio, JL:
IRYCIS, Hosp Univ Ramon y Cajal, Dept Infect Dis, Madrid, Spain
Cobo, RT:
Spanish VACH Cohort, Torrelavega, Spain
Gonzalez, PR:
Hosp Carlos III, Dept Infect Dis, Trop Med Unit, Madrid, Spain
Clotet, EP:
Spanish VACH Cohort, Tarragona, Spain
Hernando-Jerez, A:
Univ Europea Madrid, Madrid, Spain
Domingo, P:
Spanish VACH Cohort, Barcelona, Spain
Diaz, EB:
Fdn SEIMC GESIDA, Madrid, Spain
Esteban, H:
Fdn SEIMC GESIDA, Madrid, Spain
Gonzalez-Garcia, J:
Fdn SEIMC GESIDA, Madrid, Spain
IdiPaz, Madrid, Spain
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