tailieunhanh - báo cáo hóa học:" The importance of clinic attendance in the first six months on antiretroviral treatment: a retrospective analysis at a large public sector HIV clinic in South Africa"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : The importance of clinic attendance in the first six months on antiretroviral treatment: a retrospective analysis at a large public sector HIV clinic in South Africa | Brennan et al. Journal of the International AIDS Society 2010 13 49 http content 13 1 49 JOURNALOF THE INTERNATIONAL AIDS SOCIETY RESEARCH Open Access The importance of clinic attendance in the first six months on antiretroviral treatment a retrospective analysis at a large public sector HIV clinic in South Africa Alana T Brennan1 2 3 Mhairi Maskew5 Ian Sanne4 5 Matthew P Fox1 2 3 6 Abstract Background Adherence to care and treatment are essential for HIV-infected individuals to benefit from antiretroviral therapy ART . We sought to quantify the effects on treatment outcomes of missing visits soon after initiating ART. Methods We analyzed data from HIV-infected patients initiating ART at Themba Lethu Clinic Johannesburg South Africa from April 2004 to August 2008. We used log-binomial regression to evaluate the relative risk of missing visits during the first six months of ART on immunological response and virologic suppression. Cox models were used to evaluate the relationship between missed visits and mortality and loss to follow up over 12 months. Results Of 4476 patients 65 missed no visits while 26 missed one visit 7 missed two and missed three or more visits during the first six months on treatment. Patients who missed three or more medical or antiretroviral ARV visits had a two-fold increased risk of poor CD4 response by six months while the risk of failing to achieve virologic suppression by six months increased two- to five-fold among patients who missed two and three or more medical or ARV visits. Adjusted Cox models showed that patients who missed two HR 95 CI and three or more HR 95 CI medical visits had an increased risk of death while those who missed two ARV HR 95 CI or three or more medical HR 95 CI visits had an increased risk of loss to follow up. Conclusions Thirty-five percent of patients missed one or more visits in the first six months on treatment increasing their risk of