Higher Baseline CD4 Cell Count Predicts Treatment Interruptions and Persistent Viremia in Patients Initiating ARVs in Rural Uganda

被引：39

作者：

Adakun, Susan A. ^{[1
]}

Siedner, Mark J. ^{[2
]}

Muzoora, Conrad ^{[1
]}

Haberer, Jessica E. ^{[3
]}

Tsai, Alexander C. ^{[4
]}

Hunt, Peter W. ^{[5
]}

Martin, Jeff N. ^{[6
]}

Bangsberg, David R. ^{[1
,2
,7
]}

机构：

[1] Mbarara Univ Sci & Technol, Dept Med, Mbarara, Uganda

[2] Massachusetts Gen Hosp, Dept Med, Div Infect Dis, Ctr Global Hlth, Boston, MA 02114 USA

[3] Massachusetts Gen Hosp, Dept Med, Ctr Global Hlth, Div Internal Med, Boston, MA 02114 USA

[4] Massachusetts Gen Hosp, Dept Psychiat, Div Global Psychiat, Ctr Global Hlth, Boston, MA 02114 USA

[5] Univ Calif San Francisco, Dept Med, Div Infect Dis, San Francisco, CA USA

[6] Univ Calif San Francisco, Div Clin Epidemiol, Dept Epidemiol & Biostat, San Francisco, CA USA

[7] Ragon Inst Massachusetts Gen Hosp Massachusetts I, Boston, MA USA

来源：

JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES | 2013年 / 62卷 / 03期

关键词：

adherence; test and treat; Uganda; HIV/AIDS; adherence monitoring; MEMS; ACTIVE ANTIRETROVIRAL THERAPY; HIV-INFECTED ADULTS; ADHERENCE; IMPACT; AIDS; PROPHYLAXIS; PREVENTION; HOUSEHOLDS; AFRICA; RNA;

D O I：

10.1097/QAI.0b013e3182800daf

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

We examined the association between CD4 cell count and adherence in a cohort of Ugandans initiating antiretrovirals (ARVs). Outcomes were (a) adherence <90%; (b) any treatment interruptions. >72 hours; (c) number of treatment interruptions; and (d) HIV-RNA >400 copies/mL. We fit regression models to estimate associations with our exposure of interest, baseline CD4 cell count >= 250 cells/mu L (n = 60) vs <250 cells/mu L (n = 413). CD4 cell count >250 cells/mu L was independently associated with increased odds and number of treatment interruptions and increased odds of persistent viremia. Interventions to support adherence in patients with higher CD4 cell counts should be considered as drug availability to this population increases.

引用

页码：317 / 321

页数：5