Evolución de mortalidad, abandono, traslado y retención a corto, mediano y largo plazo en pacientes con infeccion por VIH: Fundación Arriarán 1990-2015.

Autores/as

  • Claudia P Cortés Facultad de Medicina Universidad de Chile Fundación Arriarán.
  • Danae Lizana Hospital Clinico San Borja Arriaran Fundacion Arriaran
  • Rebeca Northland Facultad de Medicina Universidad de Chile Fundación Arriarán.
  • Marcelo Wolff R Facultad de Medicina Universidad de Chile Fundación Arriarán.

Palabras clave:

Cohort Studies, HIV, Lost to Follow-Up, Mortality, Survival

Resumen

Background: The HIV epidemic reached Chile in late 1980s and as an early response, AIDS care centers were organized. Fundación Arriarán (FA) was the first center. Free antiretroviral therapy (ART) was later provided with progressive coverage and complexity over the years. Aim: To quantify evolution of mortality, retention and loss to follow up (LTFU) over 25 years according to different periods of access to ART, from no availability to full coverage with current drugs at FA center. Material and methods: Retrospective analysis of FA database of 5.080 adults admitted between 1990 and 2014. The sample was distributed in 7 groups: A: no ART (1990-92), B: monotherapy, C: dual therapy, D: dual/triple ART, E: early triple therapy with incomplete coverage, F same as E but with complete coverage and G: contemporary ART (2008-14). Mortality, retention and LTFU were evaluated at 1, 3, 5, 7 and 10 years and at 31/12/2015. Results: Mortality varied from 40% to 2%, and 62% to 7% at 1 and 5 years, for groups A and G respectively; from 71% to 16% at 10 years for groups A and E, respectively. Retention at 5 years were 28%, 23%, 39%, 62%, 75%, 75% and 77 % for groups A to G, respectively. LTFU was 10%, 19%, 15%, 17%, 9% 12% and 10% at 5 years for same groups, respectively. At 12/31/2015 22% of patients had died, 11% were LTFU, 60% were retained in care and 6% had been transferred. Conclusions: There is a marked reduction in mortality and increase in retention of HIV patients’ concomitant to expanded access to modern therapy, although LTFU remains a problem.

Biografía del autor/a

Claudia P Cortés, Facultad de Medicina Universidad de Chile Fundación Arriarán.

Profesor Asistente Universidad de Chile, Departamento Medicina, Campus Centro ccortes@fundacionarriaran.cl

Marcelo Wolff R, Facultad de Medicina Universidad de Chile Fundación Arriarán.

Profesor Titular Universidad de Chile

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Publicado

2018-03-22

Cómo citar

Cortés, C. P., Lizana, D., Northland, R., & Wolff R, M. (2018). Evolución de mortalidad, abandono, traslado y retención a corto, mediano y largo plazo en pacientes con infeccion por VIH: Fundación Arriarán 1990-2015. Revista Médica De Chile, 146(3). Recuperado a partir de https://revistamedicadechile.cl/index.php/rmedica/article/view/6204

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