Background:
Gender differences vary
across geographical settings and are poorly reported in the literature. The aim
of this study was to evaluate demographics and clinical characteristics of
participants from the Australian HIV Observational Database (AHOD), and to
explore any differences between females and males in the rate of new clinical
outcomes, as well as initial immunological and virological response to
antiretroviral therapy.
Methods:
Time to a new clinical
end-point, all-cause mortality and/or AIDS illness was analysed using standard
survival methods. Univariate and covariate adjusted Cox proportional hazard
models were used to evaluate the time to plasma viral load suppression in all patients that
initiated antiretroviral therapy (ART) and time to switching from a first-line
ART to a second-line ART regimen.
Results:
There was no significant
difference between females and males for the hazard of all-cause mortality
[adjusted hazard ratio: 0.98 (0.51, 1.55), P = 0.67], new AIDS illness
[adjusted hazard ratio: 0.75 (0.38, 1.48), P = 0.41] or a composite end-point
[adjusted hazard ratio: 0.74 (0.45, 1.21), P = 0.23]. Incident rates of
all-cause mortality were similar between females and males; 1.14 (0.61, 1.95)
vs 1.28 (1.12, 1.45) per 100 person years. Virological response to ART was
similar for females and males when measured as time to viral suppression and/or
time to virological failure.
Conclusion:
This study supports current
Australian HIV clinical care as providing equivalent standards of care for male
and female HIV-positive patients. Future studies should compare ART-associated toxicity
differences between ART-associated toxicity differences between men and women
living with HIV in Australia.
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By:
A Department of Infectious Diseases, Monash University, Clayton, Vic. 3168, Australia. B Monash Infectious Diseases, Monash Health, Clayton, Vic. 3168, Australia. C RPA Sexual Health, Sydney Local Health District, Sydney, NSW 2050, Australia. D The Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia. E School of Mathematical and Physical Sciences, University of Technology, Sydney, NSW 2007, Australia. F Tamworth Sexual Health Service, Tamworth, NSW 2340, Australia. G Department of Medicine, Nambour Hospital, Nambour, Qld 4560, Australia. H Central Clinical School, University of Sydney, Sydney, NSW 2052, Australia. I Corresponding author. Email: m.giles@alfred.org.au
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