Virologic outcome among patients receiving antiretroviral therapy at five hospitals in Haiti

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Jean Louis, Frantz ; Buteau, Josiane ; François, Kesner ; Hulland, Erin ; Domerçant, Jean Wysler ; Yang, Chunfu ; Boncy, Jacques ; Burris, Robert ; Pelletier, Valerie ; Wagar, Nicholas ; Deyde, Varough ; Lowrance, David W. ; Charles, Macarthur
• Description:
  Introduction
  
  Viral load (VL) assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy (ART). We conducted a retrospective cross-sectional study to evaluate the virologic suppression rate among patients on ART for ≥6 months in five hospitals around Port-au-Prince, Haiti.
  
  Methods
  
  Plasma VL was measured and patients with VL <1,000 copies/mL were defined as virologically suppressed. A second VL test was performed within at least six months of the first test. Factors associated with virologic suppression were analyzed using logistic regression models accounting for site-level clustering using complex survey procedures.
  
  Results
  
  Data were analyzed for 2,313 patients on ART for six months or longer between July 2013 and February 2015. Among them, 1,563 (67.6%) achieved virologic suppression at the first VL test. A second VL test was performed within at least six months for 718 (31.0%) of the patients. Of the 459 patients with an initial HIV-1 RNA <1,000 copies/mL who had a second VL performed, 394 (85.8%) maintained virologic suppression. Virologic suppression was negatively associated with male gender (adjusted odds ratio [aOR]: 0.80, 95% CI: 0.74–0.0.86), 23 to 35 months on ART (aOR:0.72[0.54–0.96]), baseline CD4 counts of 201–500 cells/mm3 and 200 cells/mm3 or lower (aORs: 0.77 [0.62–0.95] and 0.80 [0.66–0.98], respectively), poor adherence (aOR: 0.69 [0.59–0.81]), and TB co-infection (aOR: 0.73 [0.55–0.97]).
  
  Conclusions
  
  This study showed that over two-thirds of the patients in this evaluation achieved virologic suppression after ≥ six months on ART and the majority of them remained suppressed. These results reinforce the importance of expanding access to HIV-1 viral load testing in Haiti for monitoring ART outcomes.
  
  
• Subjects:
  Adolescent Adult Anti-HIV Agents Child Child, Preschool Female HIV-1 HIV Infections Humans Infant Infant, Newborn Male Middle Aged RNA, Viral Viral Load Young Adult

  More +
• Source:
  PLoS One. 13(1).
• Pubmed ID:
  29381736
• Pubmed Central ID:
  PMC5790273
• Document Type:
  Journal Article
• Place as Subject:
  Haiti
• Volume:
  13
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c8d30def9b027e13bfb51bae058cf28819a9d3c53ed0b876c746e7cdd1a83ebd
• Download URL:
  https://stacks.cdc.gov/view/cdc/61216/cdc_61216_DS1.pdf
• File Type:
  [PDF - 859.64 KB ]