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| DOI | 10.4067/S0716-10182016000700001 | ||||||
| Año | 2016 | ||||||
| Tipo | artículo de investigación |
Citas Totales
Autores Afiliación Chile
Instituciones Chile
% Participación
Internacional
Autores
Afiliación Extranjera
Instituciones
Extranjeras
Background: ChileanAIDS Cohort is the oldest and extensive in LatinAmerica and one of most numerous and with longer follow up time to international level. Records information from 14,873 patients out of approximately 22,000 in antiretroviral therapy in the public system and its results have allowed to know the national reality and have contributed to the adoption of public policies. Aim: To describe the demographic, clinical and immunological characteristics of patients who have started ART in Chile and its evolution over the past 15 years. Patients and Methods: The cases were stratified by five-year periods: 2001-2005, 2006-2010 and 2011-2015. The data analysis included calculating proportions, their respective confidence intervals 95% and chi(2)test for significance analysis was applied. Results: 17.4% of patients starting ART are women and the proportion has remained relatively constant. The highest proportion of new HIV cases are 30 and 39 years old, nevertheless the layer of 15-29 years demonstrates a significant increase from 21.7 to 36.4% in 2011-2015 especially in men. 12.1% of new cases are older than 50 years old with a stable trend over time; however, women over 50 have increased from 11.0 to 15.6%. Antiretroviral therapy initiation with CD4+ T lymphocytes less than 200 cells/mm(3) has decreased from 79.7 to 42.4% and in stage C from 45.4 to 22.6%. Late presentation to antiretroviral therapy is higher in men but this gap has narrowed in the last five years. Pneumocystisjiroveci, wasting syndrome, tuberculosis, Kaposi's sarcoma and esophageal candidiasis are the most common opportunistic diseases without significant changes in the three-year periods analyzed. In the last five years, 15.5% of opportunistic diseases occurs in patients with CD4+ TL > 200 cells/mm(3). Discussion: Despite the limitations of observational studies present report describes the characteristics and evolution of the epidemics in Chile in the last 15 years. The infection occurs at younger ages in men, whereas in women there is an increase over 50 years old. Despite advances in treatment access have reduced late presentation to therapy, important challenges remain to achieve more timely initiation of antiretroviral therapy in accordance with WHO 90-90-90 goals.
| Ord. | Autor | Género | Institución - País |
|---|---|---|---|
| 1 | BELTRAN-BUENDIA, CAROLL JENNY | Hombre |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 2 | Zitko, Pedro | Hombre |
Unidad Estudios Asistenciales Complejo Asistencia - Chile
Complejo Asistencial Barros Luco Trudeau - Chile Unidad de Estudios Asistenciales - Chile |
| 3 | WOLFF-REYES, MARCELO JOSE | Hombre |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 4 | Bernal, Fernando | Hombre |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 5 | Asenjo, Alicia | Mujer |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 6 | FERNANDEZ-SARMIENTO, ANA MARIA | Mujer |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 7 | BARTHEL-MUNCHMEYER, MARIA ELIZABETH | Mujer |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 8 | Wilson, Gonzalo | Hombre |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile Corporación Grupo Sida - Chile |
| 9 | AFANI-SAUD, ALEJANDRO ELIAS | Hombre | |
| 10 | Corp Grp SIDA Chile | Corporación | |
| 10 | Aguilar, C. | - | |
| 11 | Alfaro, R. | - | |
| 12 | Allendes, G. | Mujer | |
| 13 | Alejandro, A. | - | |
| 14 | Arancibia, J. | - | |
| 15 | Arredondo, S. | - | |
| 16 | Arredondo, R. | - | |
| 17 | Álvarez, C. | - | |
| 18 | Amaro, A. | - | |
| 19 | Amigo, M. | - | |
| 20 | Aylwin, M. | - | |
| 21 | Ayala, M. | - | |
| 22 | Ajraz, T. | - | |
| 23 | Alarcón, T. | - | |
| 24 | Acevedo, W. | - | |
| 25 | Arriagada, M. | - | |
| 26 | Avilés, I. | - | |
| 27 | BAHAMONDES-MOYA, LAURA | Mujer | |
| 28 | Ballesteros, Juan | Hombre | |
| 29 | BASTIAS-ONATE, CARLA BELEN | Mujer | |
| 30 | Blackburn, Eileen | Mujer | |
| 31 | BLAMEY-DIAZ, RODRIGO ARTURO | Hombre | |
| 32 | Blanco, S. | - | |
| 33 | Bugueño, R. | - | |
| 34 | Barrios, M. | - | |
| 35 | Cabrera, J. | - | |
| 36 | Cabrera, A. | - | |
| 37 | CALVO-GIL, MARIO ALFONSO | Hombre | |
| 38 | Campillay, Rolando | Hombre | |
| 39 | Carreño, V. | - | |
| 40 | Caro, Camila | Mujer | |
| 41 | Caro, I. | - | |
| 42 | Carrasco, A. | - | |
| 43 | Carvajal, E. | - | |
| 44 | Castelli, A. | - | |
| 45 | Castillo, Y. | - | |
| 46 | Cataldo, M. | - | |
| 47 | Ceballos, C. | - | |
| 48 | Chacón, M. | - | |
| 49 | CHAHIN-ANANIA, CAROLINA EUGENIA | Mujer | |
| 50 | CHANQUEO-CORNEJO, LEONARDO ANDRES | Hombre | |
| 51 | Cid, A. | - | |
| 52 | CONCHA-FUENTES, CARLA ANDREA | Mujer | |
| 53 | Contreras, P. | - | |
| 54 | CORTES-MONDACA, CLAUDIA PAZ | Mujer | |
| 55 | Cruz N, Rodrigo | Hombre | |
| 56 | Daube, Elizabeth | Mujer | |
| 57 | De Andraca, M. | - | |
| 58 | Delama, Ignacio | Hombre | |
| 59 | Díaz, V. | - | |
| 60 | Díaz, R. | - | |
| 61 | Díaz, S. | - | |
| 62 | Díaz, H. | - | |
| 63 | Escobar, V. | - | |
| 64 | Esquivel, N. | - | |
| 65 | Ewert, F. | - | |
| 66 | Ferrer, Pablo | Hombre | |
| 67 | Figueroa, L. | - | |
| 68 | Fuentealba, H. | - | |
| 69 | Fuenzalida, M. | - | |
| 70 | Fuenzalida, F. | - | |
| 71 | Gacitúa, D. | - | |
| 72 | Gaete, Pablo | Hombre | |
| 73 | Gajardo, K. | - | |
| 74 | Gallardo, Kevin | Hombre | |
| 75 | Gallo, C. | - | |
| 76 | GALVEZ-AREVALO, RICARDO | Hombre | |
| 77 | García, E. | - | |
| 78 | Gavrilovics, Alejandra | Mujer | |
| 79 | Giadalah, M. | - | |
| 80 | Goecke, B. | - | |
| 81 | González, A. | - | |
| 82 | González, G. | - | |
| 84 | González, F. | - | |
| 85 | Greppi, D. | - | |
| 86 | Guzmán, G. | - | |
| 87 | Hernández, S. | - | |
| 88 | Herrera, Patricio | Hombre | |
| 89 | Herrera, Maria Elena | - | |
| 90 | Iglesias, M. | - | |
| 91 | Irsula, A. | - | |
| 92 | Iturra, C. | - | |
| 93 | Jensen, Werner | Hombre | |
| 94 | Jorquera, V. | - | |
| 95 | LAGOS-PAILLA, LORENA MACARENA | Mujer | |
| 96 | Lasso B., Martin | Hombre | |
| 97 | Leyton, E. | - | |
| 98 | López, O. | - | |
| 99 | Marambio, Víctor | Hombre | |
| 100 | Mardones, J. | - | |
| 101 | Marincovich, B. | - | |
| 102 | Martínez, M. | - | |
| 103 | Matamala, Daniela Alejandra Zavando | Mujer | |
| 104 | Maturana, P. | - | |
| 105 | Medina, L. | - | |
| 106 | Miles, Ana | - |
Corp Grp SIDA - Chile
Corporación Grupo SIDA Chile - Chile |
| 107 | Molina, C. | - | |
| 108 | Moraga, A. | - | |
| 109 | Moreno, A. | - | |
| 110 | Munoz, Marina | Mujer | |
| 111 | MUNOZ-ROCHA, RUBEN | Hombre | |
| 114 | Muñoz, K. | - | |
| 115 | NAVARRETE-CONTRERAS, MARITZA ANGELICA | Mujer | |
| 116 | Navarro, L. | - | |
| 117 | NORTHLAND-AREYUNA, REBECA GEORGINA | Mujer | |
| 118 | Ocampo, Renato | Hombre | |
| 119 | Oñat, M. | - | |
| 120 | Orellana, L. | - | |
| 121 | Palma, V. | - | |
| 122 | Palma, Sofia | Mujer | |
| 123 | Paredes, A. | - | |
| 124 | Pérez, S. | - | |
| 125 | Pérez C., Carlos | Mujer | |
| 126 | Pérez, A. | - | |
| 127 | PINO-ZUNIGA, PAULINA | Mujer | |
| 128 | Retamal, A. | - | |
| 129 | Rodríguez, K. | - | |
| 130 | Rodríguez, L. | - | |
| 131 | Rodríguez, C. | - | |
| 132 | ROJAS-GONZALEZ, ALVARO | Hombre | |
| 133 | Rojas, L. | - | |
| 134 | Ross, E. | - | |
| 135 | Rubilar, E. | - | |
| 136 | Rusque, A. | - | |
| 137 | Salinas, V. | - | |
| 138 | Salvador, F. | - | |
| 139 | Sánchez, A. | - | |
| 140 | Sánchez, M. | - | |
| 141 | Sciaraffia, Alicia | Mujer | |
| 142 | Sepulveda, Miguel | Hombre | |
| 143 | SERRI-VENEGAS, MICHEL ANDRE | Hombre | |
| 144 | Sierralta, G. | - | |
| 145 | Silva, Macarena | Mujer | |
| 147 | Sobarzo, J. | - | |
| 148 | Solís, T. | - | |
| 149 | Soto, J. | - | |
| 150 | Stipicic, M. | - | |
| 151 | VALENZUELA-SUAZO, SANDRA VERONICA | Mujer | |
| 152 | Sutar, C. | - | |
| 153 | Tagle, Martin | Hombre | |
| 154 | Tapia, J. | - | |
| 155 | Tordecilla, Rocío | Mujer | |
| 156 | Toro, C. | - | |
| 157 | Torres, A. | - | |
| 158 | Ulloa, K. | - | |
| 159 | Usedo, Pedro | Hombre | |
| 160 | Valdebenito, Sara | Mujer | |
| 161 | VALENZUELA-PEREZ, LUCIA | Mujer | |
| 162 | Valenzuela, M. | - | |
| 163 | Valladares, C. | - | |
| 164 | Vásquez, D. | - | |
| 165 | Vasquez Toriello, Patricia T. | Mujer | |
| 166 | Vega, R. | - | |
| 167 | Vega, Claudia | Mujer | |
| 168 | Vergara, M. | - | |
| 169 | VIDAL-DIAZ, CLAUDIO | Hombre | |
| 170 | Villarroel, C. | - | |
| 171 | Yanine, D. | - | |
| 172 | Zenteno, M. | - | |
| 173 | Zuñiga, K. | - |
| Agradecimiento |
|---|
| La presentación a TARV con LT CD4 < 200 céls/mm3 se asocia a una elevada presentación de enfermedades oportunistas previas o al momento del inicio de la TARV y a CV basales elevadas. Estos eventos muestran, al igual que la presentación con LT CD4 bajos, el mismo compor-tamiento por sexo y edad y la misma tendencia a mejorar pero en forma insuficiente en los últimos años. Nuestro estudio no muestra cambios significativos en el tiempo en el tipo de enfermedades oportunistas que presentan los pacientes infectados con VIH en Chile. No obstante, en concordancia con los estudios START y Temprano, que demostraron en pacientes con diagnóstico temprano la presentación de enfermedades oportunistas con más de 500 LT CD414,15, nosotros también observamos una ten-dencia a la presentación de enfermedades de etapa C con recuentos de LT CD4 más altos en el último quinquenio, en que una mayor proporción de pacientes se presentó con menor deterioro inmunológico. Estos hallazgos enfatizan la necesidad de modificar la guía clínica de TARV chilena para ofrecer TARV a todos los pacientes con infección por VIH, de manera independiente de su recuento de LT CD4, como lo recomienda la mayoría de las guías clínicas internacionales y de la OMS16-18. |