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    Apr 19, 2021
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    Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.

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    Ford N Plos One Adherence ...
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    Authors
    Ford, Nathan
    Darder, Marta
    Spelman, Tim
    Maclean, Emi
    Mills, Edward
    Boulle, Andrew
    Affiliation
    Médecins Sans Frontières, Cape Town, South Africa. nathan.ford@joburg.msf.org
    Issue Date
    2010-05
    
    Metadata
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    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.
    URI
    http://hdl.handle.net/10144/110023
    DOI
    10.1371/journal.pone.0010460
    PubMed ID
    20485480
    Language
    en
    ISSN
    1932-6203
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0010460
    Scopus Count
    Collections
    HIV/AIDS

    entitlement

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