Early warning indicators for first-line virologic failure independent of adherence measures in a South African urban clinic.

Hdl Handle:
http://hdl.handle.net/10144/322655
Title:
Early warning indicators for first-line virologic failure independent of adherence measures in a South African urban clinic.
Authors:
Marconi, Vincent C; Wu, Baohua; Hampton, Jane; Ordóñez, Claudia E; Johnson, Brent A; Singh, Dinesh; John, Sally; Gordon, Michelle; Hare, Anna; Murphy, Richard; Nachega, Jean; Kuritzkes, Daniel R; Del Rio, Carlos; Sunpath, Henry; South Africa Resistance Cohort Study Team Group Authors
Journal:
AIDS Patient Care and STDs
Abstract:
Abstract We sought to develop individual-level Early Warning Indicators (EWI) of virologic failure (VF) for clinicians to use during routine care complementing WHO population-level EWI. A case-control study was conducted at a Durban clinic. Patients after≥5 months of first-line antiretroviral therapy (ART) were defined as cases if they had VF [HIV-1 viral load (VL)>1000 copies/mL] and controls (2:1) if they had VL≤1000 copies/mL. Pharmacy refills and pill counts were used as adherence measures. Participants responded to a questionnaire including validated psychosocial and symptom scales. Data were also collected from the medical record. Multivariable logistic regression models of VF included factors associated with VF (p<0.05) in univariable analyses. We enrolled 158 cases and 300 controls. In the final multivariable model, male gender, not having an active religious faith, practicing unsafe sex, having a family member with HIV, not being pleased with the clinic experience, symptoms of depression, fatigue, or rash, low CD4 counts, family recommending HIV care, and using a TV/radio as ART reminders (compared to mobile phones) were associated with VF independent of adherence measures. In this setting, we identified several key individual-level EWI associated with VF including novel psychosocial factors independent of adherence measures.
Issue Date:
Dec-2013
URI:
http://hdl.handle.net/10144/322655
DOI:
10.1089/apc.2013.0263
PubMed ID:
24320011
Language:
en
ISSN:
1557-7449
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorMarconi, Vincent Cen_GB
dc.contributor.authorWu, Baohuaen_GB
dc.contributor.authorHampton, Janeen_GB
dc.contributor.authorOrdóñez, Claudia Een_GB
dc.contributor.authorJohnson, Brent Aen_GB
dc.contributor.authorSingh, Dineshen_GB
dc.contributor.authorJohn, Sallyen_GB
dc.contributor.authorGordon, Michelleen_GB
dc.contributor.authorHare, Annaen_GB
dc.contributor.authorMurphy, Richarden_GB
dc.contributor.authorNachega, Jeanen_GB
dc.contributor.authorKuritzkes, Daniel Ren_GB
dc.contributor.authorDel Rio, Carlosen_GB
dc.contributor.authorSunpath, Henryen_GB
dc.contributor.authorSouth Africa Resistance Cohort Study Team Group Authorsen_GB
dc.date.accessioned2014-07-08T16:39:25Z-
dc.date.available2014-07-08T16:39:25Z-
dc.date.issued2013-12-
dc.identifier.citationEarly warning indicators for first-line virologic failure independent of adherence measures in a South African urban clinic. 2013, 27 (12):657-68 AIDS Patient Care STDsen_GB
dc.identifier.issn1557-7449-
dc.identifier.pmid24320011-
dc.identifier.doi10.1089/apc.2013.0263-
dc.identifier.urihttp://hdl.handle.net/10144/322655-
dc.description.abstractAbstract We sought to develop individual-level Early Warning Indicators (EWI) of virologic failure (VF) for clinicians to use during routine care complementing WHO population-level EWI. A case-control study was conducted at a Durban clinic. Patients after≥5 months of first-line antiretroviral therapy (ART) were defined as cases if they had VF [HIV-1 viral load (VL)>1000 copies/mL] and controls (2:1) if they had VL≤1000 copies/mL. Pharmacy refills and pill counts were used as adherence measures. Participants responded to a questionnaire including validated psychosocial and symptom scales. Data were also collected from the medical record. Multivariable logistic regression models of VF included factors associated with VF (p<0.05) in univariable analyses. We enrolled 158 cases and 300 controls. In the final multivariable model, male gender, not having an active religious faith, practicing unsafe sex, having a family member with HIV, not being pleased with the clinic experience, symptoms of depression, fatigue, or rash, low CD4 counts, family recommending HIV care, and using a TV/radio as ART reminders (compared to mobile phones) were associated with VF independent of adherence measures. In this setting, we identified several key individual-level EWI associated with VF including novel psychosocial factors independent of adherence measures.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to AIDS Patient Care and STDsen_GB
dc.subjectHIV/AIDSen_GB
dc.titleEarly warning indicators for first-line virologic failure independent of adherence measures in a South African urban clinic.en
dc.identifier.journalAIDS Patient Care and STDsen_GB

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