Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa
European Journal of Clinical Microbiology and Infectious Diseases, Volume 27, No. 10, Year 2008
Notification
URL copied to clipboard!
Description
The purpose of this study was to assess the one-year efficacy of highly active antiretroviral therapy (HAART) administered by general practitioners in a primary care community clinic in rural South Africa. We performed an observational cohort study of 675 treatment-naïve human immunodeficiency virus (HIV)-infected patients (including 66 children) who began HAART at least 12 months prior to the data analyses. Throughout treatment, the CD4+ T-cell count (percentage of CD4+ T-cells in children) and plasma HIV-RNA level were determined and the patient's weight was recorded. The primary outcome was mortality. Secondary outcomes were viral suppression, immunological response, and weight gain. One year after the start of HAART, 100 of the 675 (15%) patients were lost to follow-up and 119 patients (18%), including six children, died. Mortality was highest during the first few months of treatment. Based on an on-treatment analysis at one year after the start of therapy, 83% of adults and 71% of children had a viral load <400 copies/ml; the viral load was <50 copies/ml in 70% of adults and 61% of children. At one year, the mean CD4+ T-cell count in adults had increased by 236/mm3, and the mean body mass index (BMI) had increased by 3.5 kg/m2. In children, the mean CD4% had increased by 17.6. A low Karnofsky score and a low baseline CD4+ T-cell count were independently associated with death. In addition to these factors, a low baseline BMI and gender were predictive of a poor immunological outcome. Our study shows that adequately monitored HIV/acquired immunodeficiency syndrome (AIDS) care administered by general practitioners and their staff is feasible and leads to good results in a rural, primary care center in sub-Saharan Africa. In order to achieve even better results, early mortality should be reduced and efforts should be made to start HAART earlier. © 2008 The Author(s).
Authors & Co-Authors
Barth, Roos E.
Netherlands, Utrecht
Eijkman-winkler Center for Microbiology, Infectious Diseases and Inflammation Univeristy Medical Center Utrecht
van der Meer, Jan T.M.
Netherlands, Amsterdam
Universiteit Van Amsterdam
Hoepelman, Andy I.M.
Netherlands, Utrecht
Eijkman-winkler Center for Microbiology, Infectious Diseases and Inflammation Univeristy Medical Center Utrecht
Schrooders, P. A.
South Africa
Ndlovu Medical Centre
Van De Vijver, D. A.M.C.
Netherlands, Utrecht
University Medical Center Utrecht
Geelen, Sibyl P.M.
Netherlands, Utrecht
University Medical Center Utrecht
Tempelman, Hugo A.
South Africa
Ndlovu Medical Centre
Statistics
Citations: 64
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1007/s10096-008-0534-2
ISSN:
09349723
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa