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Virologic outcome among patients receiving antiretroviral therapy at five hospitals in Haiti.

作者信息

Jean Louis Frantz, Buteau Josiane, François Kesner, Hulland Erin, Domerçant Jean Wysler, Yang Chunfu, Boncy Jacques, Burris Robert, Pelletier Valerie, Wagar Nicholas, Deyde Varough, Lowrance David W, Charles Macarthur

机构信息

Centers for Disease Control and Prevention, Port-au-Prince, Haiti.

Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti.

出版信息

PLoS One. 2018 Jan 30;13(1):e0192077. doi: 10.1371/journal.pone.0192077. eCollection 2018.


DOI:10.1371/journal.pone.0192077
PMID:29381736
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5790273/
Abstract

INTRODUCTION: Viral load (VL) assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy (ART). We conducted a retrospective cross-sectional study to evaluate the virologic suppression rate among patients on ART for ≥6 months in five hospitals around Port-au-Prince, Haiti. METHODS: Plasma VL was measured and patients with VL <1,000 copies/mL were defined as virologically suppressed. A second VL test was performed within at least six months of the first test. Factors associated with virologic suppression were analyzed using logistic regression models accounting for site-level clustering using complex survey procedures. RESULTS: Data were analyzed for 2,313 patients on ART for six months or longer between July 2013 and February 2015. Among them, 1,563 (67.6%) achieved virologic suppression at the first VL test. A second VL test was performed within at least six months for 718 (31.0%) of the patients. Of the 459 patients with an initial HIV-1 RNA <1,000 copies/mL who had a second VL performed, 394 (85.8%) maintained virologic suppression. Virologic suppression was negatively associated with male gender (adjusted odds ratio [aOR]: 0.80, 95% CI: 0.74-0.0.86), 23 to 35 months on ART (aOR:0.72[0.54-0.96]), baseline CD4 counts of 201-500 cells/mm3 and 200 cells/mm3 or lower (aORs: 0.77 [0.62-0.95] and 0.80 [0.66-0.98], respectively), poor adherence (aOR: 0.69 [0.59-0.81]), and TB co-infection (aOR: 0.73 [0.55-0.97]). CONCLUSIONS: This study showed that over two-thirds of the patients in this evaluation achieved virologic suppression after ≥ six months on ART and the majority of them remained suppressed. These results reinforce the importance of expanding access to HIV-1 viral load testing in Haiti for monitoring ART outcomes.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64bf/5790273/28d812c19311/pone.0192077.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64bf/5790273/28d812c19311/pone.0192077.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64bf/5790273/28d812c19311/pone.0192077.g001.jpg

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本文引用的文献

[1]
Durable Suppression of HIV-1 after Virologic Monitoring-Based Antiretroviral Adherence Counseling in Rakai, Uganda.

PLoS One. 2015-5-26

[2]
Development of an electronic medical record based alert for risk of HIV treatment failure in a low-resource setting.

PLoS One. 2014-11-12

[3]
Immuno-haematologic and virologic responses and predictors of virologic failure in HIV-1 infected adults on first-line antiretroviral therapy in Cameroon.

Infect Dis Poverty. 2014-1-30

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HIV-1 virologic failure and acquired drug resistance among first-line antiretroviral experienced adults at a rural HIV clinic in coastal Kenya: a cross-sectional study.

AIDS Res Ther. 2014-1-23

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Clin Infect Dis. 2014-1

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Clin Infect Dis. 2013-9-27

[7]
Virologic and immunologic outcome of HAART in Human Immunodeficiency Virus (HIV)-1 infected patients with and without tuberculosis (TB) and latent TB infection (LTBI) in Addis Ababa, Ethiopia.

AIDS Res Ther. 2013-7-10

[8]
Virologic, clinical and immunologic responses following failure of first-line antiretroviral therapy in Haiti.

J Int AIDS Soc. 2012-6-14

[9]
Virological response and HIV drug resistance 12 months after antiretroviral therapy initiation at 2 clinics in Nigeria.

Clin Infect Dis. 2012-5

[10]
Immunologic criteria are poor predictors of virologic outcome: implications for HIV treatment monitoring in resource-limited settings.

Clin Infect Dis. 2011-12

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