Sherer R, Cohen M, Stieglitz K, Narra J, Jasek J, Green L, Moore B, Shott S; International Conference on AIDS.

Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuPeC3316.

R. Sherer, The CORE Center, Cook County Hospital, 1900 W. Polk Street, Room 1236, Chicago, Illinois 60612, United States, Tel.: +(312) 633-3004, Fax: +(312) 633-3002, E-mail: rsherer@hektoen.org

Methods: We assessed mortality, CD4 & viral load trends in four 6-month periods in 1997-8 in the largest HIV care site in the Midwest US via retrospective analysis of clinical, lab, & admin. data bases. Log-rank tests, Cox proport. analyses, & mult. logistic regression were performed. Results: Of 2,647 undupl.adult pts, 33% were women, 71% Afr Am, & 12% Hisp. Mean age was 38 yrs; 7% were >50 & 20% were 20-31. 61% were uninsured. Baseline (BL) CD4 & VL: 10% were >50 cells/ml, 17% 50-200, 27% 200-500, 13% >500, & 32% unknown. 25% were >500 copies/ml, 16% 500-10,000, 11% 10-50,000, 5% 50-100,000, 7% >100,000, & 35% unknown. Pts on HAART rose from 73% (Per 1) to 85% (Per 4). VL Trends: Median VLs were Per 1: 1,901 cop/ml; Per 2: >500; Per 3: 630; Per 4: 670. (P>0.005 for Per 2,3,4 vs 1). CD4 Trends: Median CD4s were Per 1: 266 cells/ml; Per 2: 252; Per 3: 270; Per 4: 295 (p = 0.003 for Per 4 vs Per 1). Mortality thru 12/99: 139 pts died (5.2%), 69 (8.2%) women & 70 (3.9%) men (p>0.0005). Pts on HAART in Per 1 were less likely to die (p = 0.029) than pts on ART. Risk of death was associated with BL CD4 (p>0.0005) & most recent VL (p = 0.003). Clinic Visits: The mean & median # of year 1 visits was 5. 23.3% of pts had > 2 visits, & 31.1% had > 8 visits in 1997-8. Afr Am & Hisp. had more visits than whites in yrs 1&2. (p = 0.045 & 0.012, resp.). Regular clinic care (>1 visit/6mos) was associated with significantly lower VL in all periods than non-regular care. Conclusions: Positive HIV outcomes were achieved in this large urban poor cohort, including significant viral load reductions in all periods compared to baseline, a median VL > 675 cop/ml for 1.5 years, & a significant rise of 30-36 CD4 cells from period 1 to 4. Mortality was low overall, higher in women, and lower in pts on HAART compared to 2 drug ART. Regular clinic care correlated with lower viral loads; irregular F/U in one quarter of pts remains an important issue.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Adult
• Antigens, CD4
• Antiretroviral Therapy, Highly Active
• CD4 Lymphocyte Count
• CD4-Positive T-Lymphocytes
• Chicago
• Female
• HIV Infections
• HIV Seropositivity
• Humans
• Laboratory Techniques and Procedures
• Male
• Viral Load
• immunology
• mortality
• organization & administration

Other ID:

• GWAIDS0001784

UI: 102239277

From Meeting Abstracts