Carmody E, Diaz T, Starling P, Rocha Beruthdos Santos AP, Sacks H; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. B10599.

Mount Sinai School of Medicine, New York, United States

BACKGROUND: The Brazilian public health system has implemented free, universal access to anti-retroviral therapy (ARVs) for HIV-infected patients (PTs). To evaluate this system, we did a pilot study to: 1) Describe ARV combinations used, 2) Determine whether ARVs were prescribed according to Brazilian guidelines, and 3) Determine the proportion of PTs who lacked medications for >1 month in the year. METHODS: Year 2000 data were abstracted from all medical records of adult PTs initiating HIV/AIDS treatment in a Rio de Janeiro public clinic in early 2000 (n=67). Results were analyzed with frequency analyses and chi2 tests. RESULTS: The sample was 41.8% female with a mean age of 34.8 years. 81% had AIDS (n=54); sample mean baseline CD4 and viral counts were 276 cells/mm3 and 237517 copies/ml respectively. Delays between clinic request and notation of CD4 and viral counts averaged 64 and 86 days respectively. 88.1% of PTs were prescribed ARVs (n=59). Most frequent initial regimens were zidovudine (AZT) and didanosine (DDI) (27.1%, n=16), and AZT, DDI, and nevirapine (16.9%, n=10). No combinations were prescribed that were contraindicated in Brazilian guidelines. However, 23.9% of PTs (n=16) received regimens designated as inadequate for their CD4 level, mainly those with CD4<350 on dual nucleoside therapy. 25% did not have medications for >1 month at least once during 2000 (n=17), due both to PTs not returning to refill medications and to drug shortages. Lacks tended to be associated with number of drugs in regimen (p=.16, chi2 test), but not with patient sex, age, registration date, or CD4 level. CONCLUSIONS: These results suggest good adherence to national treatment guidelines. Discrepancies between therapy and clinical measures may be due to delays in receiving CD4/viral counts. Better access to lab facilities, increased patient follow-up and greater drug availability would improve program success.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Adult
• Ambulatory Care Facilities
• Antiretroviral Therapy, Highly Active
• Brazil
• Didanosine
• Drug Therapy, Combination
• Female
• HIV Infections
• HIV Seropositivity
• Humans
• Nevirapine
• Pilot Projects
• Zidovudine
• drug therapy
• methods
• therapy

Other ID:

• GWAIDS0018441

UI: 102255939

From Meeting Abstracts