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Titolo:
Underuse of primary Mycobacterium avium complex and Pneumocystis carinii prophylaxis in the United States
Autore:
Asch, SM; Gifford, AL; Bozzette, SA; Turner, B; Mathews, WC; Kuromiya, K; Cunningham, W; Andersen, R; Shapiro, M; Rastegar, A; McCutchan, JA;
Indirizzi:
VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA VA Greater Los Angeles Healthcare Syst Los Angeles CA USA 90073 90073 USA San Diego Hlth Syst, San Diego, CA USA San Diego Hlth Syst San Diego CA USA Diego Hlth Syst, San Diego, CA USA Univ Calif Los Angeles, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA Univ Calif San Diego, San Diego, CA 92103 USA Univ Calif San Diego San Diego CA USA 92103 iego, San Diego, CA 92103 USA RAND Hlth, Santa Monica, CA USA RAND Hlth Santa Monica CA USARAND Hlth, Santa Monica, CA USA Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA Thomas Jefferson Univ Philadelphia PA USA 19107 hiladelphia, PA 19107 USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 4, volume: 28, anno: 2001,
pagine: 340 - 344
SICI:
1525-4135(200112)28:4<340:UOPMAC>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
HIV-INFECTED ADULTS; ANTIRETROVIRAL THERAPY; GUIDELINES; ADHERENCE; PREVENTION; DISEASE;
Keywords:
MAC prophylaxis; PCP prophylaxis; HIV guidelines; HIV-positive; HIV prevention;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
11
Recensione:
Indirizzi per estratti:
Indirizzo: Asch, SM VA Greater Los Angeles Healthcare Syst, 111G,11301 Wilshire Blvd,Los Angeles, CA 90073 USA VA Greater Los Angeles Healthcare Syst 111G,11301 Wilshire Blvd Los Angeles CA USA 90073
Citazione:
S.M. Asch et al., "Underuse of primary Mycobacterium avium complex and Pneumocystis carinii prophylaxis in the United States", J ACQ IMM D, 28(4), 2001, pp. 340-344

Abstract

Background: Little is known about the rates of Mycobacterium avium complex(MAC) and Pneumocystis carinii (PCP) prophylaxis adherence to guidelines and how they have changed after introduction of effective antiretroviral therapy. Objective: To determine rates of primary prophylaxis for MAC and PCP and to evaluate the influence of sociodemographic characteristics. region, and provider experience. Design: National probability sample cohort of HIV patients in care. Setting: One hundred sixty HIV health care providers. Patients: A total of 2864 patients interviewed in 1996 to 1997 (68% response) and 2267 follow-up interviews, representing 65% of surviving sampled patients (median follow-up, 15.1 months). Measurements: Use of prophylactic drugs, most recent CD4 count, sociodemographics, and regional and total HIV patients/providers. Results: Of patients eligible for primary MAC prophylaxis (most recent CD4count < 50/mm(3)), 41% at baseline and 40% at follow-up patients were treated. Of patients eligible for primary PCP prophylaxis (i.e., those with CD4counts < 200/mm(3);). 64% and 72% were treated, respectively. MAC prophylaxis at baseline was less likely in African American (adjusted odds ratio [OR], 35; 95% confidence interval [CI], 0.20-0.59), Hispanic (OR, 27; 95% CI,0.08-0.94) and less-educated (OR, 0.61; 95% Cl, 0.36-1.0) patients and more likely in U. S. geographic regions in the Pacific West (OR, 4.9; 95% Cl, 1.0-23) and Midwest (OR, 6.4; 95% Cl, 1.2-33) and in practices with more HIV patients. Conclusions: Most eligible patients did not receive MAC prophylaxis; PCP prophylaxis rates were better but still suboptimal. Our results support outreach efforts to African Americans, Hispanics, the less educated, and those in the northeastern United States and in practices with fewer HIV patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 19:41:15