Women in Serbia as late presenters‐an issue of concern

• Published in: Journal of the International AIDS Society 2012-11, Vol.15 (S4), p.1-1
• Main Authors: Dragovic, G, Ranin, J, Salemovic, D, Kusic, J, Jevtovic, D
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Antiretroviral agents; Antiretroviral drugs; HIV; Human immunodeficiency virus; Medical prognosis; Multivariate analysis; Regression analysis; Risk factors; Side effects
• ISSN: 1758-2652; 1758-2652
• DOI: 10.7448/IAS.15.6.18300

Most of the clinical trials looking at the efficacy and side effects of highly active antiretroviral therapy (HAART) have been conducted primarily on HIV‐infected males. So, we conducted a study to determine the factors influencing prognosis of HIV/AIDS and outcome in HIV/AIDS women on HAART, in a resource‐limited settings. A cross‐sectional study was performed on women, with HIV infection, who initiated HAART between 1st January 1998 and 31st December 2010, at the HIV/AIDS Center of the University Hospital for Infectious and Tropical Diseases in Belgrade, Serbia, with regular clinical and laboratory check‐ups. SPSS‐version‐11.0 software, Univariate and stepwise Multivariate logistic regression analysis together, with the Kaplan‐Meier analysis, were used to estimate risk factors influencing prognosis and outcome in HIV/AIDS women. Written consent was obtained. A total of 230 women were followed for 8.2±3.4 years (range 1–12). Durring the follow‐up, 26 patients died. The mean age of the patients at HAART initiation was 37±9.7 years. Clinical AIDS at presentation was observed in 43.9% of the patients, while 80% of them had CD4 cell counts below 200 cell/mm3. Univariate and stepwise multivariate analysis have shown that the progression to death was associated with basal CD4 counts below 100 cells/µL (OR 3.0 95% CI 1.7–8.4, P=0.02) and HCV co‐infection (OR 2.6 95% CI 1.0–6.6, P=0.03). However the NNRTI based regimens and good adherence to HAART (OR 0.2, 95% CI 0.09–0.6, P=0.005 and OR 0.3, 95% CI 0.1–0.66, P=0.03, respectively), all prevented death. Although in patients with sustained viral suppression the CD4 counts varied significantly, these did not affect overall survival (p=0.21, log rank) If HIV infected 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 achievement up to a mean 8 years of treatment, their prognosis may be fairly good even in a resource limited settings.