Estudio de la mortalidad y supervivencia en una cohorte de 1.115 pacientes con infección VIH (1989-97)

Rebollo, Francisco José; García, Rafael Rubio; Castilla, Jesús; Pulido, Federico; Palao, Guillermo; Andres, Ilenia De; Pérez-Herrero, José Ramón Costa; Pérez-Medel, Angel del Palacio

doi:10.4321/s0212-71992004001100002

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…El conteo bajo de linfocitos T CD4+ también ha documentado una relación inversamente proporcional entre el estado inmunológico y la mortalidad; un estudio en España mostró que por cada incremento de 50 linfocitos T CD4+ en el momento del diagnóstico, el riesgo de muerte disminuyó en un 83% (IC 95%: 82,0-84,0) 29 . Resultados recientes también evidencian que las PVV con recuentos de CD4 más bajos se relacionaban con mayor riesgo de mortalidad y morbilidad.…”

Section: Discussionunclassified

Supervivencia en las personas que viven con VIH en el marco del sistema de salud colombiano 2011-2018

Ramírez-García¹,

Castillo-Cañón²,

Herrera-Parra³

et al. 2021

Infect

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Objetivo: Describir la supervivencia a siete años y los principales factores asociados a esta, en las personas con VIH que fueron atendidas en el sistema de salud colombiano entre 2011 a 2018. Métodos: Análisis de supervivencia de una cohorte de 64 039 personas diagnosticadas con VIH en Colombia. Se aplicó el método de Kaplan-Meier para estimar la probabilidad de supervivencia a partir de la fecha del diagnóstico. Se ajustó un modelo de supervivencia paramétrico flexible de Royston Parmar. Resultados: La estimación de la supervivencia global a 7 años fue de 94,8% (IC 95%: 94,5-95,2). El mayor riesgo de muerte se presentó en los hombres (HR: 1,2; IC 95%: 1,1-1,4; p: 0,010); en personas ≥50 años de edad (HR: 3,1; IC 95%: 1,6-6,3; p: 0,002); en el régimen subsidiado (HR: 2,2; IC 95%: 1,9-2,5; p: <0,001); en la etapa sida (HR: 2,8; IC 95%: 2,1-3,7; p: <0,001); en quienes presentaron la última carga viral detectable (HR: 7,1; IC 95%: 6,0-8,3; p: <0,001); y en quienes mostraron conteo de linfocitos T CD4+ <350 células/μL (HR: 1,9; IC 95%: 1,4-2,4; p: <0,001). Conclusión: La probabilidad de la supervivencia de las personas que viven con VIH aumenta al ser diagnosticados en edades jóvenes, en quienes presenten un recuento de linfocitos T CD4+ ≥350 células/μL, una carga viral indetectable (< 50 copias/mL) y no se encuentren en etapa sida.

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Section: Discussionunclassified

Supervivencia en las personas que viven con VIH en el marco del sistema de salud colombiano 2011-2018

Ramírez-García¹,

Castillo-Cañón²,

Herrera-Parra³

et al. 2021

Infect

View full text Add to dashboard Cite

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The future role of rectal and vaginal microbicides to prevent HIV infection in heterosexual populations: implications for product development and prevention

et al. 2011

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Objectives To compare the potential impact of rectal(RMB), vaginal(VMB) and bi-compartment(RVMB) (applied vaginally and protective during vaginal and anal intercourse) microbicides to prevent HIV in various heterosexual populations. To understand when a RMB is as useful than a VMB for females practicing anal intercourse(AI). Methods Mathematical model was used to assess the population-level impact (cumulative fraction of new HIV infections prevented(CFP)) of the 3 different microbicides in various intervention scenarios and prevalence settings. We derived the break-even RMB efficacy required to reduce a female’s cumulative risk of HIV infection by the same amount than a VMB. Results Under optimistic coverage (fast roll-out, 100% uptake), a 50% efficacious VMB used in 75% of sex acts in population without AI may prevent ~33%[27,42%] new total (males and females combined) HIV infections over 25 years. The 25-year CFP reduces to ~25%[20,32%] and 17% [13,23%] if uptake decreases to 75% and 50%, respectively. Similar loss of impact (by 25–50%) is observed if the same VMB is introduced in populations with 5–10% AI and for RRRAI=4–20. A RMB is as useful as a VMB (i.e. break-even) in populations with 5% AI if RRRAI=20, and in populations with 15–20% AI if RRRAI=4, independently of adherence as long as it is the same with both products. The 10-year CFP with a RVMB is 2-fold larger than for a VMB or RMB when AI=10% and RRRAI=10. Conclusion Even low AI frequency can compromise the impact of VMB interventions. RMB and RVMB will be important prevention tools for heterosexual populations.

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Incremental role of male circumcision on a generalised HIV epidemic through its protective effect against other sexually transmitted infections: from efficacy to effectiveness to population-level impact

Boily

Desai

Mâsse

et al. 2008

Sexually Transmitted Infections

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Background Male circumcision(MC) can reduce HIV acquisition. However, a better understanding of the indirect protective effect of MC on sexually transmitted infections (STIs) is required. Objective To assess the incremental benefits conferred by MC on HIV infection at the individual-level in circumcision trials (no herd immunity effect) and at the population-level (with herd immunity effect) due to its protective effect against other STIs. Methods A dynamical stochastic model of HIV and STI infections in a Kenyan population was used to simulate the impact of circumcision offered to a minority of trials participants or to a large fraction of men in order to study the protective role of MC on HIV infection at the individual-level and at the population-level, respectively. Results Less than 20% of the HIV infections prevented in the circumcised arm of the circumcision trials (individual-level) could be attributable to MC efficacy against STIs rather than MC efficacy against HIV. At the population-level, MC can significantly reduce HIV prevalence especially among males and among females in the longer term. However, even at the population-level, the long-term incremental impact of MC on HIV due to the protection against STI is modest (even if MC efficacy against the STI and STI prevalence was high). Discussion The protection of MC against STI contributes little to the overall effect of MC on HIV in the trials. Additional work is needed to identify if the protective effect of MC efficacy against STIs can have a significant incremental benefit on the HIV epidemic.

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Estudio de la mortalidad y supervivencia en una cohorte de 1.115 pacientes con infección VIH (1989-97)

Cited by 4 publications

References 33 publications

Supervivencia en las personas que viven con VIH en el marco del sistema de salud colombiano 2011-2018

Supervivencia en las personas que viven con VIH en el marco del sistema de salud colombiano 2011-2018

The future role of rectal and vaginal microbicides to prevent HIV infection in heterosexual populations: implications for product development and prevention

Incremental role of male circumcision on a generalised HIV epidemic through its protective effect against other sexually transmitted infections: from efficacy to effectiveness to population-level impact

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