Lack of Prior Antiretroviral Therapy Is Associated with Increased Mortality Among Hospitalized Patients with AIDS in São Paulo, Brazil

The death rate in adults with acquired immune deficiency syndrome (AIDS) at the Institute of Infectious Diseases "Emilio Ribas" in São Paulo City has decreased significantly from 29% in 1995 to 19.8% in 1999, and hospitalization time has been reduced by 4 days in the period from 1998 to 1999. Lack of antiretroviral treatment (ART) before hospitalization was associated with death during hospitalization (odds ratio [OR] = 3.8), and survival was associated with previous use of three or more antiretrovirals (OR = 0.15). Therefore, we recommend an aggressive campaign for human immunodeficiency virus (HIV) antibody screening among the at-risk populations in Brazil to assure that ART is provided when necessary.