Impact of Unplanned Care Interruption on CD4 Response Early After ART Initiation in a Nigerian Cohort

Details

• Alternative Title:
  J Int Assoc Provid AIDS Care
• Personal Author:
  Ahonkhai, Aimalohi A. ; Adeola, Juliet ; Banigbe, Bolanle ; Onwuatuelo, Ifeyinwa ; Adegoke, Abdulkabir B. ; Bassett, Ingrid V. ; Losina, Elena ; Freedberg, Kenneth A. ; Okonkwo, Prosper ; Regan, Susan
• Description:
  The authors conducted a retrospective cohort study of unplanned care interruption (UCI) among adults initiating antiretroviral therapy (ART) from 2009 to 2011 in a Nigerian clinic. The authors used repeated measures regression to model the impact of UCI on CD4 count upon return to care and rate of CD4 change on ART. Among 2496 patients, 83% had 0, 15% had 1, and 2% had ≥2 UCIs. Mean baseline CD4 for those with 0, 1, or ≥2 UCIs was 228/cells/mm|, 355/cells/mm|, and 392/cells/mm| ( P < .0001), respectively. The UCI was associated with a 62 CD4 cells/mm| decrease (95% confidence interval [CI]: -78 to -45) at next measurement. In months 1 to 6 on ART, patients with 0 UCI gained 10 cells/µL/mo (95% CI: 7-4). Those with 1 and ≥2 UCIs lost 2 and 5 cells/µL/mo (95% CI: -18 to 13 and -26 to 16). Patients with UCI did not recover from early CD4 losses associated with UCI. Preventing UCI is critical to maximize benefits of ART.
• Subjects:
  Adult Anti-Retroviral Agents Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count Continuity Of Patient Care Female HIV Infections Humans Male Medication Adherence Nigeria Retrospective Studies

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• Keywords:
  Adherence Care Interruption CD4 HIV Infection Immunologic Recovery
• Source:
  J Int Assoc Provid AIDS Care. 16(1):98-104
• Pubmed ID:
  28084189
• Pubmed Central ID:
  PMC5289066
• Document Type:
  Journal Article
• Funding:
  R01 MH090326/MH/NIMH NIH HHSUnited States/ ; U2G PS001058/PS/NCHHSTP CDC HHSUnited States/ ; R37 AI058736/AI/NIAID NIH HHSUnited States/ ; P30 AI060354/AI/NIAID NIH HHSUnited States/ ; K23 AI106406/AI/NIAID NIH HHSUnited States/ ; R01 AI058736/AI/NIAID NIH HHSUnited States/
• Volume:
  16
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:10ebecb0181dd29b81d1151e5a557df10fa9a0dea6019bf3d170d3b2088eac34a685a318c0911429e577d1d3c10630c1360d43bd97a03fe02f766424c033eb47
• Download URL:
  https://stacks.cdc.gov/view/cdc/44053/cdc_44053_DS1.pdf
• File Type:
  [PDF - 592.83 KB ]