Herein, we present a synthesis of two publications that evaluate an abbreviated therapeutic approach to treating chronic hepatitis C virus (HCV) infection. Based on those publications, we discuss the use of the early virologic response (EVR) as a tool for the optimized management of patients under treatment, as well as reviewing concepts of HCV viral kinetics. The fourth-week EVR, characterized by HCV RNA dropping to undetectable levels, allows individuals infected with HCV genotype 1 and presenting low baseline viral loads to be treated with the combination of pegylated interferon and ribavirin for 24 weeks, whereas individuals infected with HCV genotypes 2 or 3 can be treated for only 12 weeks. Therefore, by adopting abbreviated treatment regimens optimized through early prediction of sustained viral response, it is possible to increase the number of patients treated without incurring the excess costs related to high rates of treatment failure and management of adverse outcomes, as well as avoiding the risks of unnecessarily exposing patients to drugs that have the potential to be highly toxic.

e20413th International Congress on Infectious Diseases Abstracts, Poster Presentations attending a peri-urban clinic supported by MJAP and funded by PEPFAR.Methods: From November 2005 to November 2007, consecutive treatment naive patients initiating ART at the clinic were enrolled. Clinical information is collected every month and CD4+ count measured every 6 months. This analysis includes patients who had completed at least 10 months of follow up. Response to therapy was assessed by changes in CD4 cell counts, weight, and occurrence of opportunistic infections. WHO staging, adherence levels and patient retention were also assessed.Results: During the study period, 694 of 2686 in care, started ART; the mean age was 34 years, 76% were female, 40% were in WHO stage 3&4, mean body weight was 54.5 kg (SD = 9.5) and median CD4 cell count 118/mm 3 .Outcomes could not be assessed in 19% of 694 (43 died, 50 were lost to follow up, 36 were transferred out to other health centers).The mean increase in CD4+ count at 6 months was 135/mm3 and median body weight increase was 5.0 kg. 68% of 565 active gained weight. ART initiation reduced incidence of opportunistic infections(OR:3.35, P = 0.003;). Over 98% of patients had >95% adherence. Patients with WHO stage 1&2 were twice more likely to be active compared to those with WHO stage 3&4.(OR:1.84, P = 0.002).Conclusion: HAART programs can be feasibly implemented at lower health facilities providing general outpatient care with satisfactory clinical and immunological outcomes and patient retention rates.