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Multicenter Study
. 2014 May 1;9(5):e95673.
doi: 10.1371/journal.pone.0095673. eCollection 2014.

The HIV-Brazil cohort study: design, methods and participant characteristics

Alexandre Grangeiro  1 , Maria Mercedes Escuder  2 , Alex Jones Flores Cassenote, Rosa Alencar Souza  3 , Artur O Kalichman  3 , Valdiléa G Veloso, Maria Letícia Rodrigues Ikeda  4 , Nêmora Tregnago Barcellos  4 , Carlos Brites  5 , Unai Tupinanbás  6 , Noaldo O Lucena  7 , Carlos Lima da Silva  8 , Heloisa Ramos Lacerda  9 , Beatriz Grinsztejn  10 , Euclides Ayres Castilho  1
Affiliations
Multicenter Study

The HIV-Brazil cohort study: design, methods and participant characteristics

Alexandre Grangeiro et al. PLoS One. .

Erratum in

  • PLoS One. 2014;9(7):e104119. Cassanote, Alex Jones Flores [corrected to Cassenote, Alex Jones Flores]; Veloso, Valdiléa [corrected to Veloso, Valdiléa G]

Abstract

Background: The HIV-Brazil Cohort Study was established to analyze the effectiveness of combination antiretroviral therapy (cART) and the impact of this treatment on morbidity, quality of life (QOL) and mortality. The study design, patients' profiles and characteristics of cART initiation between 2003 and 2010 were described.

Methodology/principal findings: Since 2003, the HIV-Brazil Cohort has been following HIV-infected adults receiving cART at 26 public health care facilities, using routine clinical care data and self-reported QOL questionnaires. When not otherwise available, data are obtained from national information systems. The main outcomes of interest are diseases related or unrelated to HIV; suppression of viral replication; adverse events; virological, clinical and immunological failures; changes in the cART; and mortality. For the 5,061 patients who started cART between 2003 and 2010, the median follow-up time was 4.1 years (IQR 2.2-5.9 years) with an 83.4% retention rate. Patient profiles were characterized by a predominance of men (male/female ratio 1.7∶1), with a mean age of 36.9 years (SD 9.9 years); 55.2% had been infected with HIV via heterosexual contact. The majority of patients (53.4%) initiated cART with a CD4+ T-cell count ≤200 cells/mm3. The medications most often used in the various treatment regimens were efavirenz (59.7%) and lopinavir/ritonavir (18.2%). The proportion of individuals achieving viral suppression within the first 12 months of cART use was 77.4% (95% CI 76.1-78.6). Nearly half (45.4%) of the patients presented HIV-related clinical manifestations after starting cART, and the AIDS mortality rate was 13.9 per 1,000 person-years.

Conclusions/significance: Results from cART use in the daily practice of health services remain relatively unknown in low- and middle-income countries, and studies with the characteristics of the HIV-Brazil Cohort contribute to minimizing these shortcomings, given its scope and patient profile, which is similar to that of the AIDS epidemic in the country.

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Conflict of interest statement

Competing Interests: The authors declare that the co-author Beatriz Grinsztejn is a PLOS ONE Editorial Board member. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Characteristics of the regions and sites in the HIV-Brazil Cohort Study.
Notes: ¥ Means per 100 000 population (2006 to 2010); #Per capita gross domestic product (2010); £ number of physicians per 1000 inhabitants (2010). Source: Ministry of Health/DATASUS (Information Technology Department of the Brazilian National Health Care System) and the Brazilian Institute of Geography and Statistics.
Figure 2
Figure 2. Patients included in the HIV-Brazil Cohort Study by follow-up time.
See this image and copyright information in PMC

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