High viral suppression and low attrition in healthy HIV-infected patients initiated on ART with CD4 above 500 cells/µL in a program setting in Uganda.
Adult
Ambulatory Care Facilities
Anti-HIV Agents
/ therapeutic use
Antiretroviral Therapy, Highly Active
/ methods
CD4 Lymphocyte Count
Cross-Sectional Studies
Delivery of Health Care
/ statistics & numerical data
Female
HIV Infections
/ drug therapy
Humans
Male
Uganda
/ epidemiology
Viral Load
/ drug effects
Key populations
acquired immunodeficiency syndrome
viral load
Journal
African health sciences
ISSN: 1729-0503
Titre abrégé: Afr Health Sci
Pays: Uganda
ID NLM: 101149451
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
entrez:
6
1
2021
pubmed:
7
1
2021
medline:
13
2
2021
Statut:
ppublish
Résumé
The World Health Organization recommends antiretroviral therapy (ART) for all HIV-infected patients at all CD4 counts. However, there are concerns that asymptomatic patients may have poorer viral suppression and high attrition. We sought to determine attrition and viral suppression among healthy HIV-infected patients initiated on ART in program settings. This cross-sectional study enrolled ART-experienced patients attending two PEPFAR-supported, high-volume clinics in Kampala, Uganda. Eligible patients were >18 years and had completed at least six months on ART. Participants were interviewed on socio-demographics, ART history and plasma viral load (VL) determined using Abbott Real-time. Predictors of viral suppression (<75 copies/ml) were determined using multivariate logistic regression. Overall, 267 participants were screened, 228 were eligible and 203 (89%) retained in care (visit within 90 days). Of the 203 participants, 115 (56.7%) were key-populations. Viral suppression was achieved in 173 patients (85%; 95% CI, 80.3%-90.1%). The factors associated with viral suppression were prior VL tests (AOR 6.98; p-value <0.001) and receiving care from a general clinic (AOR 5.41; p=0.009). Asymptomatic patients initiated on ART with high baseline CD4 counts, achieve high viral suppression with low risk of attrition. VL monitoring and clinic type are associated with viral suppression.
Sections du résumé
BACKGROUND
BACKGROUND
The World Health Organization recommends antiretroviral therapy (ART) for all HIV-infected patients at all CD4 counts. However, there are concerns that asymptomatic patients may have poorer viral suppression and high attrition.
OBJECTIVES
OBJECTIVE
We sought to determine attrition and viral suppression among healthy HIV-infected patients initiated on ART in program settings.
METHODS
METHODS
This cross-sectional study enrolled ART-experienced patients attending two PEPFAR-supported, high-volume clinics in Kampala, Uganda. Eligible patients were >18 years and had completed at least six months on ART. Participants were interviewed on socio-demographics, ART history and plasma viral load (VL) determined using Abbott Real-time. Predictors of viral suppression (<75 copies/ml) were determined using multivariate logistic regression.
RESULTS
RESULTS
Overall, 267 participants were screened, 228 were eligible and 203 (89%) retained in care (visit within 90 days). Of the 203 participants, 115 (56.7%) were key-populations. Viral suppression was achieved in 173 patients (85%; 95% CI, 80.3%-90.1%). The factors associated with viral suppression were prior VL tests (AOR 6.98; p-value <0.001) and receiving care from a general clinic (AOR 5.41; p=0.009).
CONCLUSION
CONCLUSIONS
Asymptomatic patients initiated on ART with high baseline CD4 counts, achieve high viral suppression with low risk of attrition. VL monitoring and clinic type are associated with viral suppression.
Identifiants
pubmed: 33402901
doi: 10.4314/ahs.v20i1.18
pii: jAFHS.v20.i1.pg132
pmc: PMC7750048
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
132-141Informations de copyright
© 2020 Byonanebye DM et al.
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