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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Predictors of attrition and immunological failure in HIV-1 patients on highly active antiretroviral therapy from different healthcare settings in mozambique
PLoS ONE, Volume 8, No. 12, Article e82718, Year 2013
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Description
In Mozambique, the evaluation of retention in HIV care and ART programmes is limited. To assess rate and predictors of attrition (no retention in care) and HAART effectiveness in HIV-1 infected patients who pay for medication and laboratory testing in Mozambique, we conducted a multicenter survey of HIV-1-infected patients who started HAART during 2002-2006. Cox proportional hazard models were used to assess risk of attrition and of therapy failure. Overall, 142 patients from 16 healthcare centers located in the capital city Maputo were followed-up for 22.2 months (12.1-46.7). The retention rate was 75%, 48% and 37% after one, two and three years, respectively. Risk of attrition was lower in patients with higher baseline CD4 count (P = 0.022) and attending healthcare center 1 (HCC1) (P = 0.013). The proportion of individuals with CD4 count ≤200 cells/mL was 55% (78/142) at baseline and decreased to 6% (3/52) at 36 months. Among the patients with available VL, 86% (64/74) achieved undetectable VL levels. The rate of immunologic failure was 17.2% (95% CI: 12.6-22.9) per 100 person-years. Risk of failure was associated to higher baseline CD4 count (P = 0.002), likely reflecting low adherence levels, and decreased with baseline VL ≥10,000 copies/mL (P = 0.033). These results suggest that HAART can be effective in HIV-1 infected patients from Mozambique that pay for their medication and laboratory testing. Further studies are required to identify the causes for low retention rates in patients with low CD4 counts and to better understand the association between healthcare setting and attrition rate. © 2013 Palladino et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s001.tif
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s002.tiff
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s003.tiff
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s004.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s005.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s006.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s007.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3869714/bin/pone.0082718.s008.doc
Authors & Co-Authors
Palladino, C.
Portugal, Lisbon
Faculdade de Farmácia, Universidade de Lisboa
Spain, Madrid
Hospital General Universitario Gregorio Marañón
Briz, Verónica
Spain, Madrid
Hospital General Universitario Gregorio Marañón
Bellón, José María
Spain, Madrid
Hospital General Universitario Gregorio Marañón
Bártolo, Inês
Portugal, Lisbon
Faculdade de Farmácia, Universidade de Lisboa
Portugal, Caparica
Egas Moniz School of Health and Science
Carvalho, Patrícia
Portugal, Lisbon
Centro Hospitalar de Lisboa Ocidental
Camacho, Ricardo
Portugal, Lisbon
Centro Hospitalar de Lisboa Ocidental
Munoz-Fernandez, M. A.
Spain, Madrid
Hospital General Universitario Gregorio Marañón
Bastos, Rui
Mozambique, Maputo
Hospital Central de Maputo
Manuel, Rolanda Carmen Rafael
Mozambique, Maputo
Hospital Central de Maputo
Casanovas, José
Mozambique, Maputo
Universidade Eduardo Mondlane
Taveira, Nuno
Portugal, Lisbon
Faculdade de Farmácia, Universidade de Lisboa
Portugal, Caparica
Egas Moniz School of Health and Science
Statistics
Citations: 26
Authors: 11
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0082718
e-ISSN:
19326203
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Mozambique