title: [Evaluation of highly active antiretroviral therapy (HAART) in a cohort of patients with HIV infection in Mexico].
abstract: BACKGROUND
  The use of highly active antiretroviral therapy (HAART) for the treatment of human immunodeficiency virus (HIV) infection induces suppression of viral replication, which has been associated with a significant decrease in disease progression. The use of HAART in open populations may have a different efficacy rate than that reported in controlled clinical trials.
  
  
  OBJECTIVE
  To describe the frequency of use of HAART and the rate of successful responses, and to identify the factors associated with therapeutic failure.
  
  
  METHODS
  A cohort study was conducted in an open Mexican community attending the AIDS clinic of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ). We included 155 HIV-infected patients admitted to the clinic between January 1997 and January 2000, who started HAART and had a minimum follow-up of 6 months and at least one viral load determination after starting treatment. Clinical characteristics, HIV viral load, and CD4+ T lymphocyte counts were analyzed.
  
  
  RESULTS
  Sixty four percent of our study population achieved undetectable viral load after initiation of treatment, and 50% maintained this response during a mean follow-up period of 13.8 months. In the multivariate analysis, factors associated with therapeutic failure were: previous use of antiviral therapy, weight loss greater than 10% during treatment, and receiving HAART outside of a clinical trial.
  
  
  CONCLUSIONS
  The use of HAART in this setting had a very low success rate, similar to that reported in other studies. The use of suboptimal therapeutic regimens should be discouraged. Identification of the factors underlying the high success rate seen in controlled clinical trials as compared to the use of HAART in the community may help improve the overall results of this therapy.
authors.affiliation: Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
authors.forename: Laura
authors.initials: L
authors.lastname: Jáuregui Camargo
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ruiz-Palacios
authors.forename: Lourdes
authors.initials: L
authors.lastname: Guerrero Almeida
authors.forename: Sandra
authors.initials: S
authors.lastname: Niño Oberto
authors.forename: Anne
authors.initials: A
authors.lastname: Peasey
authors.forename: Juan
authors.initials: J
authors.lastname: Sierra Madero
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008800:Mexico; D015999:Multivariate Analysis; D012189:Retrospective Studies
vernacular_title: Evaluación de la terapia antirretroviral muy activa (TARMA) en una cohorte de pacientes con infección por VIH en México.