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High Level of Viral Suppression and Low Switch Rate to Second-Line Antiretroviral Therapy among HIV-Infected Adult Patients Followed over Five Years: Retrospective Analysis of the DART Trial

Author

Listed:
  • Cissy Kityo
  • Diana M Gibb
  • Charles F Gilks
  • Ruth L Goodall
  • Ivan Mambule
  • Pontiano Kaleebu
  • Deenan Pillay
  • Ronnie Kasirye
  • Peter Mugyenyi
  • A Sarah Walker
  • David T Dunn
  • on behalf of the DART Trial Team

Abstract

: In contrast to resource-rich countries, most HIV-infected patients in resource-limited countries receive treatment without virological monitoring. There are few long-term data, in this setting, on rates of viral suppression or switch to second-line antiretroviral therapy. The DART trial compared clinically driven monitoring (CDM) versus routine laboratory (CD4/haematology/biochemistry) and clinical monitoring (LCM) in HIV-infected adults initiating therapy. There was no virological monitoring in either study group during follow-up, but viral load was measured in Ugandan participants at trial closure. Two thousand three hundred and seventeen (2317) participants from this country initiated antiretroviral therapy with zidovudine/lamivudine plus tenofovir (n = 1717), abacavir (n = 300), or nevirapine (n = 300). Of 1896 (81.8%) participants who were alive and in follow-up at trial closure (median 5.1 years after therapy initiation), 1507 (79.5%) were on first-line and 389 (20.5%) on second-line antiretroviral therapy. The overall switch rate after the first year was 5.6 per 100 person-years; the rate was substantially higher in participants with low baseline CD4 counts (

Suggested Citation

  • Cissy Kityo & Diana M Gibb & Charles F Gilks & Ruth L Goodall & Ivan Mambule & Pontiano Kaleebu & Deenan Pillay & Ronnie Kasirye & Peter Mugyenyi & A Sarah Walker & David T Dunn & on behalf of the DAR, 2014. "High Level of Viral Suppression and Low Switch Rate to Second-Line Antiretroviral Therapy among HIV-Infected Adult Patients Followed over Five Years: Retrospective Analysis of the DART Trial," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-7, March.
    • Handle: RePEc:plo:pone00:0090772
    DOI: 10.1371/journal.pone.0090772
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    References listed on IDEAS

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    1. Antonieta Medina Lara & Jesse Kigozi & Jovita Amurwon & Lazarus Muchabaiwa & Barbara Nyanzi Wakaholi & Ruben E Mujica Mota & A Sarah Walker & Ronnie Kasirye & Francis Ssali & Andrew Reid & Heiner Gros, 2012. "Cost Effectiveness Analysis of Clinically Driven versus Routine Laboratory Monitoring of Antiretroviral Therapy in Uganda and Zimbabwe," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-10, April.
    2. Armelle Pasquet & Eugène Messou & Delphine Gabillard & Albert Minga & Ayeby Depoulosky & Sylvie Deuffic-Burban & Elena Losina & Kenneth A Freedberg & Christine Danel & Xavier Anglaret & Yazdan Yazdanp, 2010. "Impact of Drug Stock-Outs on Death and Retention to Care among HIV-Infected Patients on Combination Antiretroviral Therapy in Abidjan, Côte d'Ivoire," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-9, October.
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