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Disminución de las tasas de SIDA y mortalidad en el estudio EuroSIDA: un estudio observacional
A Mocroft1, B Ledergerber, C Katlama
1Royal Free Centre for HIV Medicine and Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK. a.mocroft@pcps.ucl.ac.uk
Lancet (London, England)
|July 11, 2003
Resumen
La eficacia sostenida de la terapia antirretroviral altamente activa (HAART) ha reducido significativamente la mortalidad por VIH-1 y las tasas de morbilidad por SIDA en toda Europa. Estos resultados positivos demuestran el HAART.
Área de la Ciencia:
- Inmunología Inmunología.
- Virología Virología.
- Epidemiología La epidemiología.
Sus antecedentes:
- El impacto a largo plazo de la terapia antirretroviral altamente activa (HAART) en las tasas de mortalidad y morbilidad por VIH-1 sigue siendo objeto de investigación.
- La evaluación de los cambios sostenidos en estas tasas es crucial para comprender la eficacia continua de HAART.
Objetivo del estudio:
- Evaluar los cambios sostenidos en las tasas de mortalidad y morbilidad por VIH-1 en toda Europa después de la introducción de HAART.
- Para analizar el impacto de las diferentes épocas de tratamiento en los resultados de los pacientes.
Principales métodos:
- Análisis de datos de 9803 pacientes en 70 centros europeos de VIH, incluidos Israel y Argentina.
- Cálculo de las tasas de incidencia de SIDA o muerte basado en el recuento de CD4 y la era del tratamiento (pre-HAART, temprano-HAART, tardío-HAART).
- Utilizó modelos multivariados de Cox para evaluar los riesgos asociados con diferentes períodos de tratamiento.
Principales resultados:
- Se observó una disminución significativa en la incidencia del SIDA o la muerte después de septiembre de 1998 (8% por período de 6 meses).
- La incidencia de todas las muertes fue significativamente menor en la era tardía de la TARA en comparación con la era temprana de la TARA para pacientes con recuentos de CD4 ≤20 células/μL.
- La incidencia de SIDA fue aproximadamente un 50% más baja en la era tardía de la HAART en comparación con la era temprana de la HAART, independientemente del recuento de CD4.
Conclusiones:
- La reducción inicial en la mortalidad y la morbilidad después de la introducción de HAART se ha mantenido.
- Los posibles efectos adversos a largo plazo de la HAART no han disminuido su eficacia en el tratamiento del SIDA.
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