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

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dc.contributor.author Brennan, Alana T en_US
dc.contributor.author Maskew, Mhairi en_US
dc.contributor.author Sanne, Ian en_US
dc.contributor.author Fox, Matthew P en_US
dc.date.accessioned 2012-01-11T21:42:54Z
dc.date.available 2012-01-11T21:42:54Z
dc.date.copyright 2010 en_US
dc.date.issued 2010-12-7 en_US
dc.identifier.citation Brennan, Alana T, Mhairi Maskew, Ian Sanne, Matthew P Fox. "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" Journal of the International AIDS Society 13:49. (2010) en_US
dc.identifier.issn 1758-2652 en_US
dc.identifier.uri http://hdl.handle.net/2144/3236
dc.description.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 1.6% 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 2.1; 95% CI: 1.0-4.3) and three or more (HR 4.7; 95% CI: 1.4-16.2) medical visits had an increased risk of death, while those who missed two ARV (HR 3.8; 95% CI: 2.5-5.8) or three or more medical (HR 3.0; 95% CI: 1.1-8.1) 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 poorer outcomes. These patients could be targeted for additional adherence counselling to help improve ART outcomes. en_US
dc.description.sponsorship United States Agency for International Development (674-A-00-08-00007-00); National Institute of Allergy and Infectious Diseases (K01AI083097) en_US
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights Copyright 2010 Brennan et al; licensee BioMed Central Ltd. en_US
dc.title 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 en_US
dc.type article en_US
dc.identifier.doi 10.1186/1758-2652-13-49 en_US
dc.identifier.pubmedid 21134297 en_US
dc.identifier.pmcid 3012655 en_US

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