Outcomes of a remote, decentralized health center-based HIV/AIDS antiretroviral program in Zambia, 2003 to 2007

Hdl Handle:
http://hdl.handle.net/10144/66015
Title:
Outcomes of a remote, decentralized health center-based HIV/AIDS antiretroviral program in Zambia, 2003 to 2007
Authors:
Elema, R; Mills, C; Yun, O; Lokuge, K; Ssonko, C; Nyirongo, N; Mtonga, V; Zulu, H; Tu, D; Verputten, M; O'Brien, D P
Journal:
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)
Abstract:
A cross-sectional study of patients living with HIV/ AIDS treated during 2003 to 2007 in decentralized, rural health centers in Zambia was performed to measure virological outcomes after 12 months of antiretroviral therapy and identify factors associated with virological failure. Data from 228 patients who started antiretroviral therapy >12 months prior were analyzed. In all, 93% received stavudine + lamivudine + nevirapine regimens, and median antiretroviral therapy duration was 23.5 months (interquartile range 20-28). Of the 205 patients tested for viral load, 177 (86%) had viral load <1000 copies/mL. Probability of developing virological failure (viral load >1000 copies/mL) was 8.9% at 24 months and 19.6% at 32 months. Predictors for virological failure were <100% adherence, body mass index <18.5 kg/m(2), and women <40 years old. Of those with virological failure who underwent 3 to 6 months of intensive adherence counseling, 45% obtained virological success. In a remote, resource-limited setting in decentralized health centers, virological and immunological assessments of patients on antiretroviral therapy >12 months showed that positive health outcomes are achievable.
Affiliation:
Médecins Sans Frontières-Holland, Lusaka/Nchelenge, Zambia; Médecins Sans Frontières-Holland, Amsterdam, Netherlands; Médecins Sans Frontières-USA, New York; Ministry of Health, Lusaka/Nchelenge, Zambia; Médecins Sans Frontières-Holland, Vancouver, Canada
Issue Date:
11-Feb-2009
URI:
http://hdl.handle.net/10144/66015
DOI:
10.1177/1545109709331472
PubMed ID:
19211930
Additional Links:
http://jia.sagepub.com/cgi/content/abstract/8/1/60
Submitted date:
2009-04-11
Type:
Article
Language:
en
ISSN:
1545-1097
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorElema, R-
dc.contributor.authorMills, C-
dc.contributor.authorYun, O-
dc.contributor.authorLokuge, K-
dc.contributor.authorSsonko, C-
dc.contributor.authorNyirongo, N-
dc.contributor.authorMtonga, V-
dc.contributor.authorZulu, H-
dc.contributor.authorTu, D-
dc.contributor.authorVerputten, M-
dc.contributor.authorO'Brien, D P-
dc.date.accessioned2009-04-23T14:34:31Z-
dc.date.available2009-04-23T14:34:31Z-
dc.date.issued2009-02-11-
dc.date.submitted2009-04-11-
dc.identifier.citationJ Int Assoc Physicians AIDS Care (Chic Ill) 2009;8(1):60-7en
dc.identifier.issn1545-1097-
dc.identifier.pmid19211930-
dc.identifier.doi10.1177/1545109709331472-
dc.identifier.urihttp://hdl.handle.net/10144/66015-
dc.description.abstractA cross-sectional study of patients living with HIV/ AIDS treated during 2003 to 2007 in decentralized, rural health centers in Zambia was performed to measure virological outcomes after 12 months of antiretroviral therapy and identify factors associated with virological failure. Data from 228 patients who started antiretroviral therapy >12 months prior were analyzed. In all, 93% received stavudine + lamivudine + nevirapine regimens, and median antiretroviral therapy duration was 23.5 months (interquartile range 20-28). Of the 205 patients tested for viral load, 177 (86%) had viral load <1000 copies/mL. Probability of developing virological failure (viral load >1000 copies/mL) was 8.9% at 24 months and 19.6% at 32 months. Predictors for virological failure were <100% adherence, body mass index <18.5 kg/m(2), and women <40 years old. Of those with virological failure who underwent 3 to 6 months of intensive adherence counseling, 45% obtained virological success. In a remote, resource-limited setting in decentralized health centers, virological and immunological assessments of patients on antiretroviral therapy >12 months showed that positive health outcomes are achievable.en
dc.language.isoenen
dc.relation.urlhttp://jia.sagepub.com/cgi/content/abstract/8/1/60en
dc.rightsArchived with thanks to Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)en
dc.subjectantiretroviral therapyen
dc.subjectHIVen
dc.subjectrural health centersen
dc.subjectsub-Saharan Africaen
dc.subjectviral loaden
dc.titleOutcomes of a remote, decentralized health center-based HIV/AIDS antiretroviral program in Zambia, 2003 to 2007en
dc.typeArticleen
dc.contributor.departmentMédecins Sans Frontières-Holland, Lusaka/Nchelenge, Zambia; Médecins Sans Frontières-Holland, Amsterdam, Netherlands; Médecins Sans Frontières-USA, New York; Ministry of Health, Lusaka/Nchelenge, Zambia; Médecins Sans Frontières-Holland, Vancouver, Canadaen
dc.identifier.journalJournal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)en
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