Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.

Hdl Handle:
http://hdl.handle.net/10144/110023
Title:
Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.
Authors:
Ford, Nathan; Darder, Marta; Spelman, Tim; Maclean, Emi; Mills, Edward; Boulle, Andrew
Journal:
PloS One
Abstract:
OBJECTIVE: Previous studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure. DESIGN: We assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five years of follow up and multivariate analysis used to model associations of baseline variables and medication adherence with time to viral suppression or failure. RESULTS: Our adherence cohort comprised 207 patients, among whom 72% were female. Median age was 30 years and median CD4 count at initiation was 55 cells/mm(3). We found no statistically significant differences between baseline characteristics and early adherence groups. Multivariate analysis adjusting for baseline CD4 and age found that patients with suboptimal baseline adherence had a hazard ratio of 2.82 (95% CI 1.19-6.66, p = 0.018) for progression to virological failure compared to those whose baseline adherence was considered optimal. CONCLUSIONS: Our longitudinal study provides further confirmation of adherence as a primary determinant of subsequent confirmed virological failure, and serves as a reminder of the importance of initial early investments in adherence counseling and support as an effective way to maximize long-term treatment success.
Affiliation:
Médecins Sans Frontières, Cape Town, South Africa. nathan.ford@joburg.msf.org
Issue Date:
May-2010
URI:
http://hdl.handle.net/10144/110023
DOI:
10.1371/journal.pone.0010460
PubMed ID:
20485480
Language:
en
ISSN:
1932-6203
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorFord, Nathanen
dc.contributor.authorDarder, Martaen
dc.contributor.authorSpelman, Timen
dc.contributor.authorMaclean, Emien
dc.contributor.authorMills, Edwarden
dc.contributor.authorBoulle, Andrewen
dc.date.accessioned2010-08-20T19:45:24Z-
dc.date.available2010-08-20T19:45:24Z-
dc.date.issued2010-05-
dc.identifier.citationEarly adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort. 2010, 5 (5):e10460 PLoS ONEen
dc.identifier.issn1932-6203-
dc.identifier.pmid20485480-
dc.identifier.doi10.1371/journal.pone.0010460-
dc.identifier.urihttp://hdl.handle.net/10144/110023-
dc.description.abstractOBJECTIVE: Previous studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure. DESIGN: We assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five years of follow up and multivariate analysis used to model associations of baseline variables and medication adherence with time to viral suppression or failure. RESULTS: Our adherence cohort comprised 207 patients, among whom 72% were female. Median age was 30 years and median CD4 count at initiation was 55 cells/mm(3). We found no statistically significant differences between baseline characteristics and early adherence groups. Multivariate analysis adjusting for baseline CD4 and age found that patients with suboptimal baseline adherence had a hazard ratio of 2.82 (95% CI 1.19-6.66, p = 0.018) for progression to virological failure compared to those whose baseline adherence was considered optimal. CONCLUSIONS: Our longitudinal study provides further confirmation of adherence as a primary determinant of subsequent confirmed virological failure, and serves as a reminder of the importance of initial early investments in adherence counseling and support as an effective way to maximize long-term treatment success.en
dc.language.isoenen
dc.rightsPublished by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permissionen
dc.titleEarly adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.en
dc.contributor.departmentMédecins Sans Frontières, Cape Town, South Africa. nathan.ford@joburg.msf.orgen
dc.identifier.journalPloS Oneen

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