Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006

To characterize the population of HIV+ Brazilian patients with late introduction of antiretroviral therapy (ARVT), using information from the Laboratory Exam Control System.

The study analyzed 84,694 patients, representing all individuals in Brazil age 15 or over with an initial CD4+ T lymphocyte count requested between 2003 and 2006, and whose ARVT start date was later than their initial CD4+ T cell count. These patients were considered antiretroviral treatment naive. The initial CD4+ T cell distribution was analyzed according to sex, age, region and year.

Most of the patients were between 15 and 49 years of age (91%); 56% were males; 76% were asymptomatic; 50% lived in the Southeastern region of the country, with an additional 20% in the South. Initial CD4+ counts for one-third of the patients were less than 200 cells/mm(3). When combined with the number of symptomatic individuals, 41% of the total group was in need of immediate ARVT. This group included 47% of the men and 53% of the patients aged 50 years and over.

Despite universal access to ARVT in Brazil, results show that a high proportion of patients initiate ARVT at an advanced stage of disease, indicating the need to develop strategies to promote early diagnosis of HIV infection nationwide.