Comparative effectiveness of first-line antiretroviral therapy: results from a large real-world cohort after the implementation of dolutegravir.

Objective: We aimed to assess the effectiveness of first-line antiretroviral therapy (ART) regimens in achieving viral suppression at 12 months, from 2014 to 2017 in Brazil.

Design: A retrospective cohort study utilizing programmatic data from the Brazilian HIV Program.

Methods: Adults (aged 15-80 years) who started ART from January 2014 to July 2017 and had a viral load 365 (±90) days after treatment initiation were included.

Determinants of survival of people living with HIV/AIDS on antiretroviral therapy in Brazil 2006-2015.

Background: We compared AIDS-related mortality rates in people living with HIV (PLHIV) starting antiretroviral therapy (ART) in Brazil during 2006-2015 and examined associated risk factors .

Methods: Data on ART use in PLHIV and AIDS mortality in Brazil was analysed with piecewise constant exponential models. Mortality rates and hazard ratios were estimated for 0-6, 6-12, 13-24, 25-36 and > 36 months of ART use and adjusted for region, age, sex, baseline CD4 cell count and calendar year of ART initiation.

Estimating HIV incidence from surveillance data indicates a second wave of infections in Brazil.

Emerging evidence suggests that HIV incidence rates in Brazil, particularly among men, may be rising. Here we use Brazil's integrated health systems data to develop a mathematical model, reproducing the complex surveillance systems and providing estimates of HIV incidence, number of people living with HIV (PLHIV), reporting rates and ART initiation rates. An age-structured deterministic model with a flexible spline was used to describe the natural history of HIV along with reporting and treatment rates.

Sociodemographic determinants of attrition in the HIV continuum of care in Brazil, in 2016.

The aim of this study was to identify sociodemographic factors associated with attrition in the 3 steps of the HIV continuum of care related to the 90-90-90 targets - access to diagnosis, treatment initiation, and virologic suppression, in Brazilian adults (15 years or older), in 2016.Programmatic data were obtained from 2 information systems from the Brazilian Ministry of Health, which register all antiretroviral therapy (ART) dispensations and all CD4 and viral load counts (VL) performed within the country's public health system. The 3 attrition indicators were late presentation to care, defined as a first CD4 count <350 cells/mm among ART-naive individuals who performed a first CD4 count in 2016; not being on ART, defined as having no recorded dispensation within the last 100 days of the year, among those who were linked to care in 2016; and not being virologically suppressed, defined as having the last recorded VL >200 copies/mL in 2016, among those with a recorded VL count who were on treatment for at least 6 months.