Brief report: effectiveness of combination antiretroviral therapy on survival and opportunistic infections in a developing world setting: an observational cohort study.
BACKGROUND
The prolonged effectiveness of antiretroviral therapy (ART) in a developing country is not well established.


METHODS
An observational database was established at the HIV clinic of the Almenara Hospital in Lima, Peru in 1996. All 564 initially antiretroviral-naive HIV-infected persons (mean CD4 count of 91 cells/mm3) who received combination ART were followed over time.


RESULTS
The overall survival rate was 96% at year 2, 94% at year 4, and 91% at year 5. Among persons who initiated therapy with CD4 counts <100 cells/mm3, the overall survival rate at 3 years was 95%. Opportunistic infections while on ART occurred in 20% of persons. Patients who received 2 reverse transcriptase (RT) inhibitors plus a protease inhibitor had slightly better survival rates and less opportunistic disease in the first year of therapy as compared with those receiving 2 RT inhibitors and a nonnucleoside reverse transcriptase inhibitor or 3 RT inhibitors.


CONCLUSIONS
This study demonstrates the long-term effectiveness of ART in a developing country urban setting. It provides evidence of the importance of continuing global financing initiatives to provide widespread HIV therapy for countries in the developing world.
Corey
Daniel M
DM
Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, Seattle, WA 98109, USA. corey005@mc.duke.edu
Kim
Hyung Woo
HW
Salazar
Raul
R
Illescas
Ricardo
R
Villena
Juan
J
Gutierrez
Luis
L
Sanchez
Jorge
J
Tabet
Stephen R
SR
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000187:drug effects*; D006751:Hospital Information Systems / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome