1489. The evolving epidemiology of people living with HIV in a developing country in the midst of an epidemic: a descriptive cohort
Session: Poster Abstract Session: Global HIV
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDweek poster.pdf (822.7 kB)
  • Background: The past five years have seen an increasing number of newly-diagnosed HIV patients in the Philippines. Evolving epidemiologic patterns and access to HAART have likely led to changes in clinical presentation and treatment outcomes.

    Methods: Charts of patients aged ≥19 years old at the HIV clinic from the time HAART became available (2003-2011) were reviewed and compared with data pre-HAART (1993-2002).

    Results: Data for 101 pre-HAART and 446 post-HAART patients were available. Mean age at first consult post-HAART (30 years, SD 7.4) was younger compared to pre-HAART (35 years, SD 8.3; p<0.001). The proportion of males (94% vs 79%), university graduates (74% vs 41%), men who had sex with men (86% vs 40%), sex with multiple partners (88% vs 67%,), and prior STI (76% vs 11%) were all significantly greater during the post-HAART era (p<0.001). HIV-PTB co-infection was common during both periods (15% vs 16% , p=0.75). Other infections pre-HAART were cryptosporidiosis (5%) and CMV retinitis (3%), while PCP (11%) and herpes zoster (2%) were more common post –HAART. The regimen most used was zidovudine, lamivudine, and nevirapine (48%). Mean increase in CD4+ T cell count from baseline was 128 (SD 113.8). The most common adverse drug reactions were nevirapine rash (12%) and anemia from zidovudine (9%). Mortality was significantly higher pre-HAART compared to post-HAART (11% vs 5%, p<0.001). Treatment failure occurred in 25% of patients on HAART, of whom 59% had initial WHO stage 4 disease.

    Conclusion: The rising incidence of new HIV cases in the Philippines is driven by younger, well-educated men who have sex with multiple male partners, and a previous STI. Tuberculosis remains a problem despite HAART access. Survival with HAART is more likely, but adverse reactions from nevirapine and zidovudine warrant cost-effectiveness evaluation. The change in patient demography calls for targeted national HIV-prevention program.

    Katerina Leyritana, MD, Department of Medicine, Section of Infectious Diseases, Philippine General Hospital, Manila, Philippines, Marissa Alejandria, MD, Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippines, Allan Tenorio, MD, Rush Presbyterian St. Lukes Medical Center, Chicago, IL and Edsel Maurice Salvana, MD, National Institutes of Health - University of the Philippines Manila, Manila, Philippines

    Disclosures:

    K. Leyritana, None

    M. Alejandria, None

    A. Tenorio, None

    E. M. Salvana, None

    See more of: Global HIV
    See more of: Poster Abstract Session

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.