Effectiveness of antiretroviral treatment in Colombia.

OBJECTIVE To evaluate the effectiveness of antiretroviral therapies and factors associated with HIV/AIDS control in a population of patients treated by the Colombian Social Security Health System (SGSSS). METHODS This was a descriptive study of 510 HIV/AIDS patients treated with antiretroviral therapies in 19 cities in Colombia from June 1992-April 2011. Factors assessed from each patient's clinical history were: viral load, CD4 count, antiretroviral treatment regimens, prescribed daily doses of medications, length of disease evolution, duration of therapy, history of opportunistic diseases, and drug costs. RESULTS Patients were predominantly male (75.1% males versus 24.9% women), with a mean age of 41.0 ± 11.4 years and an average length of disease progression of 72 months. All recommended treatment regimens were prescribed at the defined daily dose. Treatment was effective in 65.3% of patients (viral load < 50 copies per mL). Non-adherence to treatment, treatment failure, the presence of anxiety or depression, and treatment in the city of Barranquilla were associated with an increased risk of uncontrolled HIV infection. The mean annual cost of drugs per patient was US$ 2,736. CONCLUSIONS Factors associated with uncontrolled HIV infection, especially regarding treatment adherence, must be identified to promote solutions for health care programs treating patients with HIV/AIDS.