Promoting adherence to antiretroviral therapy: the experience from a primary care setting in Khayelitsha, South Africa.
AffiliationInfectious Disease Epidemiology Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. email@example.com
MetadataShow full item record
JournalAIDS (London, England)
AbstractOBJECTIVE: To describe the approach used to promote adherence to antiretroviral therapy (ART) and to present the outcomes in the first primary care public sector ART project in South Africa. DESIGN: The study is a prospective open cohort, including all adult patients naive to previous ART who received antiretroviral treatment in Khayelitsha, from May 2001 to the end of 2002. Patients were followed until their most recent visit before 31 July 2003. METHODS: Plasma viral load was determined at 3, 6, 12, 18 and 24 months after ART was initiated, and CD4 cell counts 6-monthly. Kaplan-Meier estimates were determined for the cumulative proportions of patients surviving, and patients with viral load suppression and viral rebound. RESULTS: A total of 287 patients were initiated on triple therapy. The probability of survival was 86.3% at 24 months. The median CD4 cell count gain was 288 cells/microliters at 24 months. Viral load was less than 400 copies/ml in 89.2, 84.2 and 69.7% of patients at 6, 12 and 24 months, respectively. The cumulative probability of viral rebound (two consecutive HIV-RNA measurements above 400 copies/ml) after achieving an HIV-RNA measurement below 400 copies/ml was 13.2% at 18 months. CONCLUSION: The study shows that, with a standard approach to patient preparation and strategies to enhance adherence, a cohort of patients on ART can be retained in a resource-limited setting in a developing country. A high proportion of patients achieved suppression of viral replication. The subsequent probability of viral rebound was low.
- HIV viral load response to antiretroviral therapy according to the baseline CD4 cell count and viral load.
- Authors: Phillips AN, Staszewski S, Weber R, Kirk O, Francioli P, Miller V, Vernazza P, Lundgren JD, Ledergerber B, Swiss HIV Cohort Study., Frakfurt HIV Clinic Cohort., EuroSIDA Study Group.
- Issue date: 2001 Nov 28
- Intensive adherence counselling for HIV-infected individuals failing second-line antiretroviral therapy in Johannesburg, South Africa.
- Authors: Fox MP, Berhanu R, Steegen K, Firnhaber C, Ive P, Spencer D, Mashamaite S, Sheik S, Jonker I, Howell P, Long L, Evans D
- Issue date: 2016 Sep
- Adherence to nonnucleoside reverse transcriptase inhibitor-based HIV therapy and virologic outcomes.
- Authors: Nachega JB, Hislop M, Dowdy DW, Chaisson RE, Regensberg L, Maartens G
- Issue date: 2007 Apr 17
- Effectiveness of patient adherence groups as a model of care for stable patients on antiretroviral therapy in Khayelitsha, Cape Town, South Africa.
- Authors: Luque-Fernandez MA, Van Cutsem G, Goemaere E, Hilderbrand K, Schomaker M, Mantangana N, Mathee S, Dubula V, Ford N, Hernán MA, Boulle A
- Issue date: 2013
- Time to viral load suppression in antiretroviral-naive and -experienced HIV-infected pregnant women on highly active antiretroviral therapy: implications for pregnant women presenting late in gestation.
- Authors: Aziz N, Sokoloff A, Kornak J, Leva NV, Mendiola ML, Levison J, Feakins C, Shannon M, Cohan D
- Issue date: 2013 Nov