Virological failure reduced with HIV-serostatus disclosure, extra baseline weight and rising CD4 cells among HIV-positive adults in Northwestern Uganda.
BMC Infect Dis
; 16(1): 614, 2016 Oct 28.
Article
em En
| MEDLINE
| ID: mdl-27793124
ABSTRACT
BACKGROUND:
Little is known about the incidence of virological failure among Human Immunodeficiency virus (HIV) infected adults after Uganda transitioned from Zidovidine/Lamivudine/ Nevirapine (AZT/3TC/NVP) to Tenofovir/Lamivudine/Efavirenze (TDF/3 T/EFV) as a first-line anti-retroviral therapy (ART) in 2013. This was the first study in Uganda to investigate the incidence and predictors of virological failure among HIV-positive adults in Northwestern Uganda.METHOD:
A retrospective cohort of 383 HIV-positive adults at Arua Teaching and Regional Referral Hospital HIV Clinic with at least six months of ART duration and five consecutive good adherence levels was used. Socio-demographic and clinical variables were analyzed with STATA version 12 at 5 % significance level. The Chi-squared, Fisher's exact and Student's t-tests were used for bivariate analysis. Cox Proportional Hazard Regression analysis was used for univariable and multivariate analysis, Kaplan-Meier for comparison of survival probability and the log-rank for testing survivorship probability. Hazard ratios (HR), 95 % confidence intervals (CI) and probability values were stated.RESULTS:
The average age of the cohort was 34.0 ± 11 years (Median 32 years, Interquartile range (IQR) 25-31 years). 28 (7.3 %; 95 % Confidence Interval [CI] 4.9-10.6) incident cases of virological failures and an incidence rate of 58 per 1000 person-years over risk time of 483 years was recorded. One-kilogram baseline body weight difference (41-kg and above) at ART initiation (Adjusted Hazard Ratio [aHR] = 0.86, 95 % CI0.76-0.96, P = 0.008), one-CD4 cell increase (35 cells/ul and above) after ART initiation (aHR = 0.99, 95 % CI 0.98-0.99, P < 0.001) and HIV-serostatus disclosure (aHR = 0.15, 95 % CI 0.06-033, P < 0.001) reduced the hazard of virological failure.CONCLUSION:
Virological failure is common among HIV-positive adults in Northwestern Uganda. It reduced with extra baseline weight, rising CD4 cell counts and HIV-serostatus disclosure.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Fármacos Anti-HIV
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
Africa
Idioma:
En
Revista:
BMC Infect Dis
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Uganda