title: Clinical and immunologic outcomes of HAART-treated HIV-infected women in resource constrain settings: the Belgrade Study.
abstract: We performed a study to identify factors related to favorable response to highly active-antiretroviral therapy (HAART) in HIV-infected women. A retrospective study was performed on 216 women who had initiated HAART from January 1, 1998 to December 31, 2012, at the HIV/AIDS Center, Belgrade, Serbia. Participants were followed-up for 8.2 ± 3.4 years. The mean age was 37 ± 9.7 years. During follow-up, it was found that 26 patients had died. Clinical AIDS at initiation of HAART was observed in 43.9% patients, while 64.8% had a CD4+ T-cell count below 200 cells/μL. Multivariate analyses revealed that the single factor independently related to a favorable response to HAART was good compliance (odds [OR] ratio for survival = 2.9, 95% confidence intervals [CI] = 1.0-8.6, p = 0.03), while a baseline CD4+ T-cell count below 100 cells/μL, hepatitis C virus coinfection, and aged 40 years and older were all associated with an unfavorable response to HAART (OR = 0.28, 95% CI = 0.15-0.52, p < 0.001; OR = 0.49, 95% CI = 0.22-0.8, p = 0.008; OR = 0.41, 95% CI = 0.21-0.79, p = 0.008, respectively). The estimated 14-year-survival was 100% in patients with sustained viral suppression, regardless of the CD4+ counts achieved (p = 0.6, log-rank). If women with advanced HIV-related immunodeficiency reach and maintain optimal viral suppression during HAART, regardless of the level of immune recovery, and if they continue to maintain this suppression for up to a mean 8 years of treatment, their prognosis may be fairly good, even in resource-limited settings.
authors.affiliation: a Institute for Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade , Belgrade , Serbia.
authors.forename: Gordana
authors.initials: G
authors.lastname: Dragović
authors.forename: Dubravka
authors.initials: D
authors.lastname: Salemović
authors.forename: Jovan
authors.initials: J
authors.lastname: Ranin
authors.forename: Jelena
authors.initials: J
authors.lastname: Nikolić
authors.forename: Jovana
authors.initials: J
authors.lastname: Kušić
authors.forename: Djordje
authors.initials: D
authors.lastname: Jevtović
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D055771:Serbia; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*
chemical_list: D012367:RNA, Viral