Antiretroviral therapy use in selected countries in Latin America during 2013–2017: results from the Latin American Workshop in HIV Study Group

• Published in: International journal of infectious diseases 2021-12, Vol.113, p.288-296
• Main Authors: Zitko, Pedro, Hojman, Martin, Sabato, Sofía, Parenti, Pablo, Cuini, Rosana, Calanni, Liliana, Contarelli, Jorge, Teran, Rosa, Araujo, Valeria, Bakolis, Ioannis, Chaverri, Jorge, Morales, Miguel, Arauz, Ana-Belen, Moncada, Wendy, Thormann, Mónica, Beltrán, Carlos
• Format: Article
• Language: English
• Subjects: Anti-HIV Agents - therapeutic use; Anti-Retroviral Agents - therapeutic use; HIV Infections - drug therapy; HIV Infections - epidemiology; Humans; Latin America - epidemiology; Tenofovir - therapeutic use
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2021.09.047

•There is poor documentation of antiretroviral use in Latin America•Early antiretroviral therapy (ART) initiation has improved in the region•ART and genotypification availability are unequally distributed in the region•Efavirenz remains the first option for initiating ART; Zidovudine use has decreased•Use of new antiretroviral drugs like integrase inhibitors as a third drug is delayed To document antiretroviral use in Latin America during the last decade. We collected indicators from 79 HIV health care centres in 14 Latin American Spanish-speaking countries for 2013–2017. Indicators were analysed by age, sex and other characteristics and weighted by the estimated people under care (PUC) population in each country. We gathered information on 116 299 PUC. One-third belonged to centres reporting a shortage of at least one antiretroviral therapy (ART) drug for >30 days during 2017. At end 2017, 95.1% of PUC were receiving ART. During 2013–2017, 45 329 people living with HIV were admitted to 39 centres. ART initiated during the first year after admission increased from 76.7% in 2013 to 83.8% in 2017. In 35 centres across the study period, 71.7% of PUC started ART with tenofovir disoproxil fumarate and lamivudine, and zidovudine use decreased. The third most common ART drug, EFV, reached 64.8%. Raltegravir and other alternatives increased annually to almost 10% of total use in 2017. Initial ART in Latin America is not based on the most recent scientific evidence and recommendations; use of drugs with higher efficacy and safety profiles and guarantee of ART availability continues to be a public health challenge.