In:
AIDS Research and Treatment, Hindawi Limited, Vol. 2011 ( 2011), p. 1-5
Abstract:
Objective . To define the long-term (2–4 years) clinical and virological outcome of an antiretroviral treatment (ART) programme in rural South Africa. Methods . We performed a retrospective observational cohort study, including 735 patients who initiated ART. Biannual monitoring, including HIV-RNA testing, was performed. Primary endpoint was patient retention; virological suppression (HIV-RNA 〈 50 copies/mL) and failure (HIV-RNA 〉 1000 copies/mL) were secondary endpoints. Moreover, possible predictors of treatment failure were analyzed. Results . 63% of patients (466/735) have a fully suppressed HIV-RNA, a median of three years after treatment initiation. Early mortality was high: 14% died within 3 months after treatment start. 16% of patients experienced virological failure, but only 4% was switched to second-line ART. Male gender and a low performance score were associated with treatment failure; immunological failure was a poor predictor of virological failure. Conclusions . An “all or nothing” phenomenon was observed in this rural South African ART programme: high early attrition, but good virological control in those remaining in care. Continued efforts are needed to enrol patients earlier. Furthermore, the observed viro-immunological dissociation emphasises the need to make HIV-RNA testing more widely available.
Type of Medium:
Online Resource
ISSN:
2090-1240
,
2090-1259
Language:
English
Publisher:
Hindawi Limited
Publication Date:
2011
detail.hit.zdb_id:
2573930-X
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