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Biomedical subjects

Pedro Chequer

Publications and source records attributed to Pedro Chequer.

4 recordsLinked to original sources

DBCollHIV: a database system for collaborative HIV analysis in Brazil.

We developed a database system for collaborative HIV analysis (DBCollHIV) in Brazil. The main purpose of our DBCollHIV project was to develop an HIV-integrated database system with analytical bioinformatics tools that would support the needs of Brazilian research groups for data storage and sequence analysis. Whenever authorized by the principal investigator, this system also allows the integration of data from different studies and/or the release of the data to the general public. The development of a database that combines sequences associated with clinical/epidemiological data is difficult without the active support of interdisciplinary investigators. A functional database that securely stores data and helps the investigator to manipulate their sequences before publication would be an attractive tool for investigators depositing their data and collaborating with other groups. DBCollHIV allows investigators to manipulate their own datasets, as well as integrating molecular and clinical HIV data, in an innovative fashion.

Brazil↗

Dramatic improvement in survival among adult Brazilian AIDS patients.

BACKGROUND: Since the last study of survival time among Brazilian AIDS patients, care has improved steadily, culminating in a controversial policy of universal free access to triple antiretroviral treatment since 1996. This large, national study examined how these changes have impacted survival. METHODS: Using national data for cases diagnosed in 1995 and 1996, we randomly selected 3930 adult AIDS cases from 18 cities in seven states representing all regions of Brazil. Trained abstracters reviewed medical records, determining dates of diagnosis and death or last contact, exposure category, treatment, and demographics. After review, 2821 cases met the inclusion criteria and were available for Kaplan-Meier and proportional hazards analysis. Data from the earlier study were re-analyzed for comparison. RESULTS: Median survival was 5 months for cases diagnosed in the 1980s, 18 months for those diagnosed in 1995, and 58 months for those diagnosed in 1996. Predictors of longer survival in univariate analysis included antiretroviral treatment, year of diagnosis, higher education, sexual exposure category, female sex, and Pneumocystis carinii pneumonia prophylaxis. In multivariate analysis, the predictive value of most of these was attenuated or disappeared, leaving antiretroviral treatment as the main predictor of survival. CONCLUSIONS: Survival time has increased substantially for adult Brazilian AIDS patients. The timing of these gains and analysis of the predictors of survival both indicate antiretroviral treatment as the cause. These findings demonstrate that universal access to antiretroviral treatment in a developing country can produce benefits on the same scale as in richer countries.

Acquired Immunodeficiency Syndrome↗

Access to antiretroviral treatment in Latin American countries and the Caribbean.

OBJECTIVES: To assess the access to antiretroviral therapy in the Latin America and Caribbean region and the main issues involved. METHODS: A review of National AIDS Programmes reports, published studies on HIV access to antiretroviral drugs, and personal communications from National AIDS Programmes in the region. RESULTS: Most countries have, or are in the process of developing, laws and regulations to ensure better access to antiretroviral drugs for people in need. However, there are still many countries that either have not implemented policies or do not have policies. There has been an important decrease in the cost of drugs, but prices are still too high for all countries to afford them. The benefits in decreased mortality and hospitalizations in the countries with high coverage are significant. The number of people receiving antiretroviral therapy has been estimated to be close to 170,000 individuals; however, this figure only represents a fraction of the people in need in the region. Some different strategies will have to be implemented in order to increase coverage. CONCLUSION: Renewed efforts are needed from both governments and international community organizations to strengthen the health services and increase access to antiretroviral drugs.

Acquired Immunodeficiency Syndrome↗