Abstract

ECHEVARRIA ZARATE, Juan et al. Effectiveness of highly active antiretroviral therapy (HAART) on HIV patients treated in a public hospital in Lima, Peru.. Rev Med Hered [online]. 2007, vol.18, n.4, pp.184-191. ISSN 1018-130X.

In May 2004, the Peruvian Ministry of Health in collaboration with the Global Fund to fight AIDS, tuberculosis and malaria, implemented a national program (NP) to provide highly active antiretroviral therapy (HAART) free of charge to all HIV-infected patients who fulfilled the NP’s guidelines. Objective: To evaluate the efficacy, safety and impact on mortality of HAART on HIV patients of a public hospital. Material and methods: We reviewed medical records, medical files, laboratory results and HAART charts of all patients enrolled within the NP at the Hospital Nacional Cayetano Heredia and described pre-treatment characteristics, response to HAART, toxicity and mortality rates. Study subjects were confirmed HIV-infected individuals who: (i) were > 18 years of age; (ii) started HAART under the NP between May 2004 and April 2006, and (iii) were naïve for antiretroviral treatment. Successful virological response was defined as at least one undetectable viral load (HIV-1 RNA < 400 copies/mL) determination 3 to 6 months after the initiation of HAART. Results: A total of 453 patients were included in the study: 68% were male; the mean age was 35.7 ±9.5 years and mean body weight was 55.6±10.8 Kg. Mean baseline CD4 cell count was 98 cells/mm3 and viral load was 278,438 copies/mL. Eighty-four patients discontinued HAART (22 abandoned treatment, 59 died and 3 were transferred to another institution). For those who continued HAART, the mean follow-up time was 337 days; 38% (142/369) temporarily interrupted HAART mainly due to drug toxicity (82%). Successful virological response was achieved in 85% of patients. Overall mortality was 13% and 74% of deaths occurred within the first 3 months of treatment. Conclusion: Despite of a high frequency of treatment interruption, our results show that the response to drugs provided by the NP is comparable to that reported by programs in other countries. Further studies should be performed to evaluate long-term outcome of HAART in Peru. (Rev Med Hered 2007;18:184-191).

Keywords : Global Fund; HAART; antiretroviral treatment.

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