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

Abstract

PURPOSE: To characterize the population of HIV+ Brazilian patients with late introduction of antiretroviral therapy (ARVT), using information from the Laboratory Exam Control System. METHODS: 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. RESULTS: 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/mm³. 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. CONCLUSIONS: 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.