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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Promoting adherence to antiretroviral therapy: The experience from a primary care setting in Khayelitsha, South Africa
AIDS, Volume 18, No. SUPPL. 3, Year 2004
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Description
Objective: 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/μl 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. © 2004 Lippincott Williams & Wilkins.
Authors & Co-Authors
Coetzee, David John
South Africa, Cape Town
University of Cape Town
South Africa, Cape Town
Faculty of Health Sciences
Boulle, Andrew
South Africa, Cape Town
University of Cape Town
Hildebrand, Katherine
South Africa, Cape Town
University of Cape Town
Asselman, Valerie
Switzerland, Geneva
Medecins Sans Frontieres
Van Cutsem, Gilles
Switzerland, Geneva
Medecins Sans Frontieres
Goemaere, Eric
Switzerland, Geneva
Medecins Sans Frontieres
Statistics
Citations: 190
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1097/00002030-200406003-00006
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Study Locations
South Africa