Declines in highly active antiretroviral therapy initiation at CD4 cell counts ≤ 200 cells/μL and the contribution of diagnosis of HIV at CD4 cell counts ≤ 200 cells/μL in British Columbia, Canada.

Autor: Lourenço L; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Samji H; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Nohpal A; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Chau W; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Colley G; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Lepik K; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Barrios R; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Lima V; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Hogg RS; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada., Montaner J; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada., Kesselring S; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada., Moore DM; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Jazyk: angličtina
Zdroj: HIV medicine [HIV Med] 2015 Jul; Vol. 16 (6), pp. 337-45. Date of Electronic Publication: 2015 Feb 27.
DOI: 10.1111/hiv.12212
Abstrakt: Objectives: The aim of the study was to examine trends in initiating highly active antiretroviral therapy (HAART) with a CD4 count ≤ 200 cells/μL and the contribution of having a CD4 count ≤ 200 cells/μL at the time of diagnosis to these trends, in British Columbia (BC), Canada.
Methods: We included in the analysis treatment-naïve BC residents aged ≥ 19 years who initiated HAART from 2003 to 2012. Participants were classified as follows: Group 1: diagnosed and initiated HAART with a CD4 count > 200 cells/μL; Group 2: diagnosed with a CD4 count > 200 cells/μL and initiated HAART with a CD4 count ≤ 200 cells/μL; and Group 3: diagnosed and initiated HAART with a CD4 count ≤ 200 cells/μL. We measured trends in initiating HAART with a CD4 count ≤ 200 cells/μL and used logistic regression models to measure factors associated with initiating HAART with a CD4 count ≤ 200 cells/μL, stratified by having a CD4 count ≤ 200 cells/μL or > 200 cells/μL at the time of diagnosis.
Results: Between 2003 and 2012, 3506 BC residents initiated HAART. Of these, 44% (1558 of 3506) initiated HAART with a CD4 count ≤ 200 cells/μL. This proportion declined from 69% (198 of 287) in 2003 to 21% (81 of 330) in 2012 (P < 0.001). The proportion of those in Group 3 increased from 49% (97 of 198) in 2003 to 69% (56 of 81) in 2012 (P < 0.001). Overall, 56% (1948), 22% (776) and 22% (782) made up Groups 1, 2, and 3, respectively. In adjusted analyses, seeing a specialist was significantly associated with being in Group 3. Using injection drugs and seeing a specialist were associated with being in Group 2.
Conclusions: In recent years, among individuals who ever initiated HAART in BC, being diagnosed with low CD4 cell counts has become a greater contributor to initiating HAART with low CD4 cell counts.
(© 2015 British HIV Association.)
Databáze: MEDLINE
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