AEGiS-13IAC: Factors influencing survival in HIV infected patients treated with HAART.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Factors influencing survival in HIV infected patients treated with HAART.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB417)

Carmona A, Knobel H, Guelar A, Grau S, Mateu-de Antonio J, Lopez-Colomes JL, Saballs P
A. Carmona, IMAS, Hospital del Mar, Passeig Maritim 25-29, 08003 Barcelona, Spain, Tel.: +34 93 221 04 16, Fax: +34 93 221 04 16, E-mail: 91422@imas.imim.es

OBJECTIVE: To assess which factors influence on the survival of HIV infected patients treated with HAART.

METHOD: The study was carried out in a 450-bed university hospital in Barcelona (Spain). Patients included were those infected by HIV that started HAART (2 nucleoside analogues + 1 protease inhibitor) between June 1996 and June 1999. A pharmacist assessed adherence by routinely personal interview and pill count. Patients were considered adherents when took more than 90% of the prescribed doses. Mortality data were extracted from Hospital records and city census. Statistics: Chi-square, Kaplan-Meir and Cox methods were used for univariate and multivariate analysis. Factors studied were: sex, age, group of risk, AIDS (group C of CDC HIV classification), basal CD4 count, viral load, and adherence to HAART.

RESULTS: Patients included were 736. Men: 69%, mean age: 37.1 é 8.8 years, intravenous drug users: 45%, homosexuals: 21%, heterosexuals: 32%, AIDS: 29.5%, mean baseline CD4 count: 273.9 é 223.7 cel/mL, mean baseline viral load: 71036.6 é 256684.1 ARN copies/mL, adherents: 68%, mean time of follow-up: 93.5 é 37.55 weeks. Deaths: 29 patients (3.9%). In a multivariate analysis, the only factors related to mortality were adherence and AIDS. Mortality rate in adherent and non-adherent patients were 1.8% and 8.4% respectively (p > 0.0001), RR (95% CI) = 0.33 (0.15-0.74). Number needed to adhere to prevent one death (NNA) = 1/absolute risk reduction = 15 patients. Mortality rate in AIDS and non-AIDS patients were 9.8% and 1.5% respectively (p > 0.0001), RR (95% CI) = 3.60 (1.5-8.9). Mortality rates in adherent and non-adherent AIDS patients were 4.7% and 17.2%, RR (95% CI) = 0.52 (0.37-0.72). NNA = 8 patients.

CONCLUSIONS: In the HAART era, adherence has a significant influence on HIV-patients' survival. Every 15 adherent patients, one death can be prevented. It is of the utmost importance to spend resources in programs to improve adherence in these patients.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV Infections, CD4 Lymphocyte Count, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Viral Load, Substance Abuse, Intravenous, Heterosexuality, Survival, Homosexuality, Spain, Human, Male, mortality, pathogenicity
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TuOrB417