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RETROVIRUS RESEARCH CENTER

RETROVIRUS RESEARCH CENTER. CLINICAL, SOCIODEMOGRAPHIC AND IMMUNOLOGICAL PROFILE: BEFORE, DURING AND AFTER THE IMPLEMENTATION OF HAART THERAPY. Universidad Central del Caribe School of Medicine, University Hospital Ramon Ruiz Arnau Bayamon, Puerto Rico. Puerto Rico Health Regions.

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RETROVIRUS RESEARCH CENTER

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  1. RETROVIRUS RESEARCH CENTER CLINICAL, SOCIODEMOGRAPHIC AND IMMUNOLOGICAL PROFILE: BEFORE, DURING AND AFTER THE IMPLEMENTATION OF HAART THERAPY. Universidad Central del Caribe School of Medicine, University Hospital Ramon Ruiz Arnau Bayamon, Puerto Rico

  2. Puerto Rico Health Regions

  3. Rationale • Retrovirus Research Center has been collecting data prospectively since 1992 • Availability of HAART began shortly after 1995 • Data on socio-demographic, clinical and immunological variables are available for study.

  4. Methods • Study Design: • A cross sectional study from a longitudinal cohort. • Setting: • The study group comes from the Bayamon area in the northern part of the island. Our health facilities serves eleven municipalities with a population of 660,440 inhabitants. • Study Group: • 3,151 HIV infected patients seen between 1992 through 2002.

  5. Methods • Variables: • Period of entry: (1992-1995, 1996-1998, 1999-2002) • Sociodemographic: age, gender. • HIV transmission mode and risk behaviors: IDU, heterosexual, MHSM, others • Clinical presentation (Stage of infection, patterns of chronic diseases, and profile of OI, medical therapy) • Immunological variables( CD4, CD8, HIV viral load • Survival analysis (time between AIDS diagnosis and last event (death or not death).

  6. Methods • Statistical Analyses: • Frequency, Percents, Mean, Median, SD, proportions, mortality rates. • Differences in proportions: Chi-Square, Fisher Exact test • Differences in mean: T-test for independent samples ANOVA. • Survival Analyses: Kaplan Meier procedure and Cox Model. • The overall significance level used was set to 0.05. • The statistical package used was SPSS 11.0 for Windows.

  7. Patient Flow Chart TOTAL (at December 2002) MALE 76% 72% 66% FEMALE 24% 28% 34% P=.0001

  8. Stage at Presentation Percent Years P=.0001

  9. AGE OF PATIENTS AT STUDY ENTRY Percent Years p<.0001

  10. Mean Age at Entry P<0.01

  11. AGE AND ENTRY WITH CLINICAL AIDS Percent Years P=.0001

  12. HIV RISK SCENARIO Percent P=.0001

  13. AIDS DEFINING CONDITIONS AS PER YEAR Percent of Patients <1996 1996-98 >1998 *p<.01

  14. PRESENCE OF CHRONIC CONDITIONS PERCENT OF PATIENTS <1996 1996-98 >1998 P<001

  15. USE OF ANTIRETROVIRAL THERAPY PERCENT OF PATIENTS ART <1996 1996-98 >1998 P<001

  16. Median Levels of CD4 Cell Count Per Year of Entry * P<.026

  17. Early MortalityMortality prior to last day of first interval Percent P<.0001

  18. MEDIAN OF SURVIVAL BY HIV/AIDS DIAGNOSIS

  19. Survival analysis within the HIV patientsdescribe by years of entry, n=982. P<.0001

  20. Survival analysis within the AIDS diagnosed patients describe by years of entry, n=2167. P< .0001

  21. CONCLUSIONS • INCREASED • FEMALES • HETEROSEXUAL BEHAVIOR AS RISK • AGE (OLDER PATIENTS IN PARTICULAR >55Y) • PATIENTS WITH IMMUNOLOGICAL AIDS AT ENTRY • CHRONIC CONDITIONS (DM,CV) • USE OF HAART INTERVENTION • MEDIAN SURVIVAL IN HIV AND AIDS

  22. CONCLUSIONS • DECREASED • IVU AS RISK FACTOR • CLINICAL AIDS AND HIV STAGE AT ENTRY • TOTAL CD4 CELL COUNT IN HIV AND AIDS • PCP, TOXO, TB AS INFECTIONS IN AIDS) • MORTALITY WITHIN SIX MONTHS OF ENTRY

  23. THANKS • INVESTIGATORS: • Robert Hunter Mellado, MD, FACP • María A. Gómez Escudero, Ph.D. • Diana M. Fernández Santos, MS, Ed.D. (candidate) • Angel M. Mayor Becerra, MD, MS • Eddy Ríos Olivares, Ph.D., MPH • José W. Rodríguez, Ph.D. • Carlos Leon Valiente, MD • Beatriz Martinez Ph.D. • Jose Rodriguez Ph.D. • Boukli Nawal Ph.D. • Data Analysts • Doris V. Báez Feliciano, MS • Alejandro Amill Rosario, MPH • Miriam Velázquez Díaz, MS • Data Abstractors • Gisela I. Cestero Salas, BA • Glenda L. Ortiz Torres, BA • Heidy Ortiz Marrero, BA • Data Entry • Wanda I. Marín Maldonado • Information Systems Specialist • Magaly Torres Talavera, BBA • Administrative Support • Lillian Santana Báez, BBA

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