[Evolution of mortality and current status of an HIV-infected population cared for at a comprehensive HIV/AIDS center in Chile].
BACKGROUND
Chile, a middle-income country with an HIV epidemic of moderate proportions (global infection rate 0.2%) began a government sponsored, free, highly active antiretroviral therapy (HAART) for patients from the public health system in 2001 reaching in 2004 a 100% coverage. Arriaran Foundation (AF) is the largest public AIDS care center for adults in the country.


OBJECTIVE
To show the present status of the AF population and the evolution of mortality.


METHODS
Review of AF database from 1991-2004 that at 12/31/2004 had a total cumulative population of 2,259 adult patients; an active census of 1,065 patients and admitting rate 160-190 patients per years.


RESULTS
The global mortality registered was 33.4%, with decreasing annual mortality from 15.7% of its active population in 1995 to 1.9% in 2004. As of 12/31/2004, 817 patients (76.7%) were receiving antiretroviral therapy (ART); and 19.3% either did not require nor accept it. Thirty one percent received Combivir and nevirapine, with undetectable viral load (<400 copies per ml) in 78%. Thirty percent received Combivir and efavirenz with undetectable viral load in 80% at last count. Both regimens were used mainly as first therapy. Lopinavir/ritonavir was received by 6.3% of patients, mainly for post failure therapy and 58% had undetectable viral load. A baseline CD4 count <200 x mm(3) was present in 70% of patients, 45.3% had a count below 100 and 47.8% had clinical AIDS. At the last follow up assessment, CD4 count was <200 in 36.8%, <100 in 10.6% and 200-350 in 44.9%.


CONCLUSIONS
The expanded access program to ART in a public, comprehensive AIDS care center in Chile has been highly successful in reaching high undetectability (75%), reducing mortality and improving immune status despite very advanced baseline disease.
Wolff R
Marcelo
M
Fundación Arriarán, Hospital Clínico San Borja Arriarán, Chile. mwolff@vtr.net
Alvarez P
Patricia
P
Flores S
Ingrid
I
Northland A
Rebeca
R
Wolff L
Claudia
C
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology / Q000401:mortality; D000328:Adult; D018791:CD4 Lymphocyte Count; D002677:Chile / Q000453:epidemiology; D005260:Female; D005582:Foundations; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000401:mortality*; D006679:HIV Seropositivity / Q000276:immunology; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D016896:Treatment Outcome; D019562:Viral Load