1357. Mortality and Retention in Care of HIV-Infected Patients According to Year of Admission and Availability of Antiretroviral Drugs in the Chilean National AIDS Program: Fundacion Arriaran 1990-2015
Session: Poster Abstract Session: HIV Care Continuum
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • ID week poster Mortality and Retention in Care in HIV-Infected Patients.pdf (783.6 kB)
  • Background: The HIV epidemic reached Chile in the mid 1980s, as response a national AIDS commission was created, AIDS care centers were organized (Fundacion Arriaran [FA] was the first) and free antiretroviral therapy (ART) was later provided with progressive coverage, complexity and availability over the years

    Objective: Quantify evolution of mortality, retention and abandonment (LTFU) over 25 years according to qualitatively different periods in the national program of access to ART, from no availability to full coverage with current drugs at FA center

    Methods: Retrospective analysis of FA updated database of the 5080 adult patients admitted from 1990 to 2014, who were distributed in 4 groups: A: no ART availability (1990-92); B: mono/dual ART (1993-98); C: early modern ART (HAART) (1999-2007) and D: contemporary HAART (2008-14). Mortality, Retention and LTFU were evaluated at 1, 3, 5 and 10 year intervals from admission and at end of 2015. Mortality was included in period of occurrence; LTFU was permanent absence at center of > 6 months during studied period. Local IRB approved the study

    Results: Main results shown in Table. Mortality varied from 40% to 2%, and 62% to 7% at 1 and 5 years, for groups A and D respectively; 72% to 16% at 10 years for groups A and C, respectively. Retention at 5 years were 28%, 32%, 72% and 77% for groups A, B, C and D respectively. LTFU was 10%, 17%, 12% and 10% at 5 years for same groups, respectively. At 12/2015 6%, 19%, 61% and 84% from groups A, B, C and D, respectively, remained retained in care

    Mortality (M) Retention (R) and Abandonment (Ab) in %

    Year 1

    Year 3

    Year 5

    Year 10

    Dec 2015

    M

    R

    Ab

    M

    R

    Ab

    M

    R

    Ab

    M

    R

    Ab

    M

    R

    Ab

    A n 330

    No ARV available (1990-92)

    40

    55

    5

    48

    45

    7

    62

    28

    10

    71

    14

    14

    75

    6

    15

    B n 882

    Pre HAART therapy (1993-98)

    29

    61

    9

    45

    39

    14

    50

    32

    17

    54

    26

    19

    57

    19

    20

    C n 1690

    Early HAART (1999-2007)

    7

    84

    7

    9

    78

    10

    13

    72

    12

    16*

    63*

    14*

    17

    61

    14

    D n 2178

    Contemporary HAART (2008-14)

    2

    91

    4

    5

    83

    8

    7*

    77*

    10*

    4

    84

    6

    Mortality, retention and abandonment according to periods of admission and at end of 2015, in %.

    * Calculated with proportion of patients completing that period.

    Transfers: 0-8% for each period. Data not in table.

    Conclusion: This study showed the marked reduction in mortality and increase in retention of HIV patients concomitant to expanded access to therapy although LTFU remains a problem.

    Marcelo Wolff, MD1, Rebeca Northland, MD2, Danae Lizana, data manager2 and Claudia P. Cortes, MD1,2, (1)Medicine, University of Chile School of Medicine, Santiago, Chile, (2)Fundacion Arriaran, Santiago, Chile

    Disclosures:

    M. Wolff, None

    R. Northland, None

    D. Lizana, None

    C. P. Cortes, None

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