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Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.

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dc.contributor Médecins Sans Frontières, Cape Town, South Africa. nathan.ford@joburg.msf.org
dc.creator Ford, Nathan
dc.creator Darder, Marta
dc.creator Spelman, Tim
dc.creator Maclean, Emi
dc.creator Mills, Edward
dc.creator Boulle, Andrew
dc.date 2010-05
dc.date.accessioned 2017-01-31T07:18:18Z
dc.date.available 2017-01-31T07:18:18Z
dc.identifier Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort. 2010, 5 (5):e10460 PLoS ONE
dc.identifier 1932-6203
dc.identifier 20485480
dc.identifier 10.1371/journal.pone.0010460
dc.identifier http://hdl.handle.net/10144/110023
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/110023
dc.identifier PloS One
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/110023
dc.description OBJECTIVE: Previous studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure. DESIGN: We assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five years of follow up and multivariate analysis used to model associations of baseline variables and medication adherence with time to viral suppression or failure. RESULTS: Our adherence cohort comprised 207 patients, among whom 72% were female. Median age was 30 years and median CD4 count at initiation was 55 cells/mm(3). We found no statistically significant differences between baseline characteristics and early adherence groups. Multivariate analysis adjusting for baseline CD4 and age found that patients with suboptimal baseline adherence had a hazard ratio of 2.82 (95% CI 1.19-6.66, p = 0.018) for progression to virological failure compared to those whose baseline adherence was considered optimal. CONCLUSIONS: Our longitudinal study provides further confirmation of adherence as a primary determinant of subsequent confirmed virological failure, and serves as a reminder of the importance of initial early investments in adherence counseling and support as an effective way to maximize long-term treatment success.
dc.language en
dc.rights Published by Public Library of Science, [url]http://www.plosone.org/[/url] Archived on this site by Open Access permission
dc.title Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.


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