We assessed mortality and disease progression in the largest Midwest HIV primary care site via retrospective analysis of clinical and laboratory data. Of 2,647 patients, 33% were women, 71% AA, 12% Hispanic, mean age 38 years, 61% uninsured. Baseline CD4 & VL: 10% <50 cells/ml, 17.4% 50-200, 27.5% 200-500, 13.3% >500, & 31.7% unknown and 25% <500 copies/ml, 16.4% 500-10,000, 11.3% 10-50,000, 4.7% 50-100,000, 7% >100,000, & 35.2% unknown. HAART use increased from 73% to 85%. Median VL decreased from 1,901 to 670 (P<0.005). Median CD4s increased from 266 cells/ml to 295(p=0.003). 139 patients died (7.2%), 69 (8.2%) women & 70 (3.9%) men (p<0.0005). Patients on HAART were less likely to die (p=0.029) than patients on ART. Risk of death was associated with baseline CD4 (p<0.0005) & most recent VL (p=0.003). The mean & median # of year 1 clinic visits was five. 23.3% of pts had < 2 visits, & 31.1% had > 8 visits. AA and Hispanics had more visits than whites (p=0.045 & 0.012). Regular clinic care (>1 visit/6mos) was associated with significantly lower VL in all periods than non-regular care. Conclusions: Positive HIV outcomes were achieved in this urban poor cohort, including significant viral load reductions in all periods compared to baseline, a median VL < 675 cop/ml for 1.5 years, & a significant rise of CD4 cells. Mortality was low overall, higher in women, and lower in HAART users compared to ART users. Regular clinic care correlated with lower VL; irregular F/U remains important.
Learning Objectives: Participants will describe trends in HIV health outcomes accomplished through receiving regular care
Keywords: Medical Care, Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The CORE Center of Cook County Hospital
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment