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Rev Panam Salud Publica. 2016 Dec;40(6):448-454.

The HIV care cascade in Buenos Aires, Argentina: results in a tertiary referral hospital.

Author information

1
Fundación Huésped, Investigaciones Clínicas, Buenos Aires, Argentina.
2
Hospital General de Agudos Juan A. Fernández, Infectología, Buenos Aires, Argentina.
3
Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
4
Hospital General de Agudos Juan A. Fernández, Farmacia, Buenos Aires, Argentina.
5
Dirección de Sida y ETS, Ministerio de Salud, Buenos Aires, Argentina.

Abstract

Objective:

To determine rates of retention, antiretroviral therapy (ART) use, and viral suppression in an adult cohort from a public tertiary referral hospital in the city of Buenos Aires, Argentina.

Methods:

HIV-positive ART-naïve patients ≥ 18 years old starting care 2011-2013 contributed data until the end of 2014. Three outcomes were assessed in 2014: retention in care, ART use, and viral suppression. Patient characteristics associated with each outcome were assessed through logistic regression.

Results:

A total of 1 031 patients were included. By the end of 2014, 1.5% had died and 14.8% were transferred to a different center. Of the remaining 859 patients, 563 (65.5%) were retained in 2014. Among those retained, 459 (81.5%) were on ART in 2014. Of those 459 on ART, 270 (58.8%) were virologically suppressed. Younger age was associated with lower retention (OR (odds ratio): 0.67; 95% CI (confidence interval): 0.44-0.92 for ≥ 35 vs. < 35 years), but unrelated with ART use or viral suppression. Low CD4 count at first visit was associated with ART use (OR: 35.72 for CD4 < 200, 7.13 for CD4 200-499 vs. ≥ 500, P < 0.001) and with virologic suppression (OR: 2.17 for CD4 < 200, 2.46 for CD4 200-499 vs. ≥ 500, P: 0.023).

Conclusions:

Our hospital in Buenos Aires is still below the recommended 90-90-90 targets of the Joint United Nations Programme on HIV/AIDS (UNAIDS) for ART use and viral suppression. We found a major gap in retention in care. Identifying younger age as being associated with worse retention will help in the design of targeted interventions.

PMID:
28718494
PMCID:
PMC5518480
[Indexed for MEDLINE]
Free PMC Article

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