Can Routine Clinical Markers Be Used Longitudinally to Monitor Antiretroviral Therapy Success in Resource‐Limited Settings?

Bagchi, Shashwatee; Kempf, Mirjam Colette; Westfall, Andrew O.; Maherya, Anastasiya; Willig, James H.; Saag, Michael S.

doi:10.1086/510072

Cited by 42 publications

(37 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Akileswaran and others suggested that the frequency of CD4 cell count monitoring of patients to be every 6 months (25). Other study proposed CD4 cell counts determination to be as often as monthly to every 3 months (27). The hospital had only one machine for CD4 determination which breaks frequently; otherwise according to the Ethiopian guideline it could have been done every 6 months.…”

Section: Discussiomentioning

confidence: 99%

Immunologic and clinical outcomes of children on HAART: A retrospective cohort analysis at Jimma University Specialized Hospital

Workneh¹,

Girma²,

Woldie³

2011

Ethiop J Health Sci

View full text Add to dashboard Cite

BACKGROU D:The nature of human immunodeficiency virus infection in children has changed from an often fatal to a treatable chronic condition with highly active antiretroviral therapy. The outcome of the therapy depends on multiple factors such as non-adherence to treatment, selection of resistant viral strains, drug toxicity and socioeconomic factors. The objective of this study was to determine the immunologic and clinical outcomes of children who are on highly active antiretroviral therapy at the ART clinic, Jimma University Specialized Hospital. METHOD: A three -year's retrospective cohort analysis was conducted in July 2008 among children younger than 14 years of age getting highly active antiretroviral therapy in Jimma University Specialized Hospital. Data was collected using a pre-tested record review format and analyzed using SPSS for Windows version 16.0 and World Health Organization Anthro v2.0.2 software. RESULT: Fifty three (55.2%) of the 96 patients were female, the mean age at initiation of treatment was 6 ± 4.2 years and the mean follow-up period was 13.7 ± 8 months. By the time of the study, 69 (71.9 %) patients were still on follow-up, 7 (7.3%) had died, 13 (13.5%) were lost to follow-up and the remaining 7(7.3%) were transferred-out. Majority (93.8%) of them were at WHO stage 3&4 during initiation of treatment. Median Weight-for-age Z-score improved from 0.09 to 0.26 after 6 month of treatment. Immunologic treatment failure was seen in 11(11.5%) of the patients; 5 of them also manifested clinical treatment failure. Severe drug toxicity occurred in 5 (5.2%) cases. Presence of chronic gastroenteritis, WHO clinical stage 4 at initiation and appearance of new opportunistic infection after starting treatment were associated with immunologic treatment failure (p <0.03). CO CLUSIO : Majority of the patients were having advanced clinical stage at initiation of treatment. Mortality rate and anthropometric changes of HIV infected children on highly active antiretroviral therapy were similar but immunologic treatment failure, loss to follow-up and severe drug toxicity were higher in this study compared to other reports from developing countries. Therefor, early diagnosis and treatment of HIV/AIDS and treatment monitoring should be strengthened.

show abstract

Section: Discussiomentioning

confidence: 99%

Immunologic and clinical outcomes of children on HAART: A retrospective cohort analysis at Jimma University Specialized Hospital

Workneh¹,

Girma²,

Woldie³

2011

Ethiop J Health Sci

View full text Add to dashboard Cite

show abstract

“…Incomplete VL suppression during therapy leads to the emergence and evolution of drug resistance, reducing treatment options and resulting in the transmission of resistant mutants (7). Neither clinical findings nor CD4 cell counts are adequate predictors of viral suppression, and in fact management by CD4 cell counts alone can lead to unnecessary treatment changes (1). VL testing is the only reliable marker for the early detection of the failure of antiretroviral therapy (17,20).…”

mentioning

confidence: 99%

Comparative Evaluation of the ExaVir Load Version 3 Reverse Transcriptase Assay for Measurement of Human Immunodeficiency Virus Type 1 Plasma Load

Labbett¹,

Garcı́a-Dı́az²,

Fox³

et al. 2009

J Clin Microbiol

View full text Add to dashboard Cite

In resource-limited settings, the virological monitoring of antiretroviral therapy is limited by high cost and the lack of infrastructure. The Cavidi ExaVir Load assay employs a simple and inexpensive enzyme-linked immunosorbent assay format to measure human immunodeficiency virus (HIV) reverse transcriptase activity, which correlates with plasma RNA load. The version 3 assay has been described as having improved precision and sensitivity. There are limited data on its performance relative to those of current real-time assays

show abstract

“…Optimal clinical outcomes require maximal suppression of viral replication with combination therapy, and current World Health Organization recommendations to assess adherence, clinical findings, and changes in CD4 cell count cannot predict virologic HAART failure [43,44]. In addition, drug-resistant HIV infection represents a real public health threat, because the transmission of such infection limits the usefulness of certain HAART regimens.…”

mentioning

confidence: 99%

Running with Scissors: Using Antiretroviral Therapy without Monitoring Viral Load

Smith

Schooley

2008

CLIN INFECT DIS

View full text Add to dashboard Cite

Can Routine Clinical Markers Be Used Longitudinally to Monitor Antiretroviral Therapy Success in Resource‐Limited Settings?

Cited by 42 publications

References 10 publications

Immunologic and clinical outcomes of children on HAART: A retrospective cohort analysis at Jimma University Specialized Hospital

Immunologic and clinical outcomes of children on HAART: A retrospective cohort analysis at Jimma University Specialized Hospital

Comparative Evaluation of the ExaVir Load Version 3 Reverse Transcriptase Assay for Measurement of Human Immunodeficiency Virus Type 1 Plasma Load

Running with Scissors: Using Antiretroviral Therapy without Monitoring Viral Load

Contact Info

Product

Resources

About