Late-onset opportunistic infections while receiving anti-retroviral therapy in Latin America: burden and risk factors.
AIDS
Cohort studies
HIV
Latin America
Opportunistic infections
Tuberculosis
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
11
11
2021
revised:
28
04
2022
accepted:
23
06
2022
pubmed:
30
6
2022
medline:
9
9
2022
entrez:
29
6
2022
Statut:
ppublish
Résumé
The aim of this study was to describe the incidence, clinical characteristics, and risk factors of late-onset opportunistic infections (LOI) in people who live with HIV (PWLHA) within the Caribbean, Central and South America network for HIV epidemiology. We performed a retrospective cohort study including treatment-naive PWLHA enrolled at seven sites (Argentina, Brazil, Chile, Peru, Mexico, and two sites in Honduras). Follow-up began at 6 months after treatment started. Outcomes were LOI, loss to follow-up, and death. We used a Cox proportional hazards model and a competing risks model to evaluate risk factors. A total of 10,583 patients were included. Median follow up was at 5.4 years. LOI occurred in 895 (8.4%) patients. Median time to opportunistic infection was 2.1 years. The most common infections were tuberculosis (39%), esophageal candidiasis (10%), and Pneumocystis jirovecii (P. jirovecii) pneumonia (10%). Death occurred in 576 (5.4%) patients, and 3021 (28.5%) patients were lost to follow-up. A protease inhibitor-based regimen (hazard ratio 1.25), AIDS-defining events during the first 6 months of antiretroviral-treatment (hazard ratio 2.12), starting antiretroviral-treatment in earlier years (hazard ratio 1.52 for 2005 vs 2010), and treatment switch (hazard ratio 1.31) were associated with a higher risk of LOI. LOI occurred in nearly one in 10 patients. People with risk factors could benefit from closer follow-up.
Identifiants
pubmed: 35768025
pii: S1201-9712(22)00375-7
doi: 10.1016/j.ijid.2022.06.041
pmc: PMC9851270
mid: NIHMS1834307
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
469-475Subventions
Organisme : NIAID NIH HHS
ID : U01 AI069476
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069923
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI069476
Pays : United States
Informations de copyright
Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
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