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      Impact of highly active antiretroviral therapy (HAART) on the incidence of opportunistic infections, hospitalizations and mortality among children and adolescents living with HIV/AIDS in Belo Horizonte, Minas Gerais State, Brazil Translated title: Impacto da terapia anti-retroviral de alta potência (HAART) na incidência de infecções oportunistas, hospitalização e mortalidade associadas em crianças e adolescentes vivendo com HIV/AIDS em Belo Horizonte, Minas Gerais, Brasil

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          Abstract

          The impact of highly active antiretroviral therapy (HAART) can be evaluated using indicators, such as rates of opportunistic infections, hospitalizations by cause of infection, and associated death. This study aimed to estimate the impact of HAART on the incidence of these indicators, in children and adolescents with HIV/AIDS. It was a hybrid cohort study; 371 patients were followed from 1989 to 2003. In December 2003, 76% of the patients were still being followed, while 12.1% had died, 9.5% had dropped out, and 2.4% had been transferred. The overall rate of opportunistic infections was 18.32 infections/100 persons-year and 2.63 in the pre- and post-HAART periods, respectively. In the multivariate analysis, the risk of developing an opportunistic infection was 5.4 times greater and 3.3 times greater for hospitalization risk before HAART. Respiratory causes represented 65% of the hospitalizations and they were reduced by 44.6% with therapeutic intervention. The average hospital stay of 15 days was reduced to 9.There was a post-HAART decline in deaths of 38%. This study demonstrates the effectiveness of HAART in significantly reducing opportunistic infections, hospitalizations, and deaths in this Brazilian cohort.

          Translated abstract

          O impacto da terapia anti-retroviral de alta potência ativa (HAART) pode ser avaliado utilizando-se indicadores, como taxas de incidências de infecções oportunistas, hospitalizações por causas infecciosas e mortalidade associada. O objetivo deste trabalho foi estimar o impacto da HAART na incidência desses indicadores em crianças e adolescentes com HIV/AIDS. Trata-se de uma coorte híbrida, na qual foram acompanhados 371 pacientes no período de 1989-2003. Em dezembro de 2003, 76% dos pacientes permaneciam em acompanhamento, 12,1% faleceram, 9,5% foram perda de seguimento e 2,4% transferidos. A taxa de incidência global de infecções oportunistas foi de 18,32 infecções/100 pessoas-ano e 2,63 nos períodos pré e pós-HAART, respectivamente. Na análise multivariada, risco relativo de desenvolvimento de infecção oportunista foi 5,4 vezes maior e 3,3 vezes maior para hospitalizações, antes da HAART. Causas respiratórias representaram 65% das hospitalizações, sendo reduzidas em 44,6% com a intervenção terapêutica. A mediana de duração das hospitalizações apresentou queda: 15 para 9 dias. Houve 38% de declínio nos óbitos pós-HAART. Este estudo demonstrou a efetividade da HAART, associando-a com significativa redução na incidência das infecções oportunistas, hospitalizações e mortalidade nesta coorte brasileira.

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          Correlates of opportunistic infections in children infected with the human immunodeficiency virus managed before highly active antiretroviral therapy

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            Correlates of opportunistic infections in children infected with the human immunodeficiency virus managed before highly active antiretroviral therapy

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              Author and article information

              Contributors
              Role: ND
              Role: ND
              Role: ND
              Role: ND
              Role: ND
              Role: ND
              Role: ND
              Journal
              csp
              Cadernos de Saúde Pública
              Cad. Saúde Pública
              Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro )
              1678-4464
              2007
              : 23
              : suppl 3
              : S414-S423
              Affiliations
              [1 ] Universidade Federal de Minas Gerais Brazil
              [2 ] Universidade Federal de Minas Gerais Brazil
              [3 ] Universidade Federal de Minas Gerais Brazil
              Article
              S0102-311X2007001500009
              10.1590/S0102-311X2007001500009
              b8991350-a421-471e-b1f6-69ce490f12af

              http://creativecommons.org/licenses/by/4.0/

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              Product Information: website
              Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=0102-311X&lng=en
              Categories
              Health Policy & Services

              Public health
              Highly Active Antiretroviral Therapy,Oppurtunist Infections,HIV,Terapia Anti-Retroviral de Alta Atividade,Infecções Oportunistas

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