PREVALENCE OF DISCORDANT IMMUNOLOGIC AND VIROLOGIC RESPONSES IN PATIENTS WITH AIDS UNDER ANTIRETROVIRAL THERAPY IN A SPECIALIZED CARE CENTER IN BRAZIL

Revista Do Instituto De Medicina Tropical De São Paulo

Endereço:
AV. DR. ENéAS DE CARVALHO AGUIAR 470
São Paulo / SP
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ISSN: 364665
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Início Publicação: 31/05/1959
Periodicidade: Bimestral
Área de Estudo: Medicina

PREVALENCE OF DISCORDANT IMMUNOLOGIC AND VIROLOGIC RESPONSES IN PATIENTS WITH AIDS UNDER ANTIRETROVIRAL THERAPY IN A SPECIALIZED CARE CENTER IN BRAZIL

Ano: 2011 | Volume: 53 | Número: 6
Autores: Janaina Aparecida Schineider CASOTTI, Luciana Neves PASSOS, Fabiano José Pereira de OLIVEIRA, Crispim CERUTTI Jr
Autor Correspondente: Fabiano José Pereira de OLIVEIRA | [email protected]

Palavras-chave: Acquired immunodeficiency syndrome, CD4 lymphocyte count, Highly active antiretroviral therapy, Discordant immunologic and virologic responses

Resumos Cadastrados

Resumo Inglês:

Some patients under antiretroviral therapy (ART) do not reach immune recovery when the viral load becomes undetectable. This is called discordant immunologic and virologic responses. Its prevalence varies between 8% and 24%. This study describes its prevalence and the characteristics of the affected subjects in the outpatient clinic of a Brazilian specialized-care center. Of 934 patients on ART, 536 had undetectable viral loads. Prevalence was 51/536 or 9% (95% confidence interval: 6.6% to 11.4%). Median age at the beginning of ART was 37 years (interquartile range - IQR: 31 to 45). Male gender and mixed race predominated (76.5% and 47.1% respectively). AIDS-defining illnesses were absent at the beginning of ART in 60.8%. Fifty-one percent were taking protease inhibitors, 43.2% Efavirenz and 5.8% both. Median time on ART was 36 months (IQR: 17-81 months). Irregular treatment was recorded for 21.6%. ART had been modified for 63% prior to the study, and 15.7% had used monotherapy or double therapy. Median CD4 count was 255 cells/mm3 (IQR: 200-284). Median viral load before ART was 4.7 log10 copies/mL (IQR: 4.5-5.2). Discordant responders were not different from AIDS patients in general, but there was a high frequency of multiple schedules of treatment.