High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa

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dc.contributor.authorGarone, D B
dc.contributor.authorConradie, K
dc.contributor.authorPatten, G
dc.contributor.authorCornell, M
dc.contributor.authorGoemaere, W
dc.contributor.authorKunene, J
dc.contributor.authorKerschberger, B
dc.contributor.authorFord, N
dc.contributor.authorBoulle, A
dc.contributor.authorVan Cutsem, G
dc.date.accessioned2021-10-08T07:17:48Z
dc.date.available2021-10-08T07:17:48Z
dc.date.issued2013
dc.description.abstractObjective. To describe and evaluate the outcomes of a support programme for patients with virological failure while receiving second-line antiretroviral therapy (ART) in South Africa.Method. We described a comprehensive medical and counselling patient support programme for patients receiving secondline ART and with two consecutive viral loads (VLs) >1 000 copies/ml. Patients with >3 months follow-up and at least one VL measurement after inclusion in the programme were eligible for analysis.Results. Of 69 patients enrolled in the programme, 40 had at least one follow-up VL and no known drug resistance at enrolment; 27 (68%) of these re-suppressed while remaining on second-line ART following enhanced adherence support. The majority (18/27; 67%) achieved re-suppression within the first 3 months in the programme. Five patients with diagnosed second-line drug resistance achieved viral re-suppression (<400 copies/ml) after being switched to third-line ART. Seven patients (7/40; 18%) did not achieve viral re-suppression after 9 months in the programme: 6 with known adherence problems (4 without drug resistance on genotype) and 1 with a VL <1 000 copies/ml. Overall, 3 patients (4%) died, 3 (4%) were lost to follow-up and 2 (3%) were transferred out.Conclusion. Our experience from a routine programme demonstrates that with targeted adherence support, the majority of patients who were viraemic while receiving second-line ART returned to an undetectable VL within 3 months. By increasing the time receiving second-line ART and decreasing the need for genotypes and/or third-line ART, this intervention may reduce costs.
dc.identifier.apacitationGarone, D. B., Conradie, K., Patten, G., Cornell, M., Goemaere, W., Kunene, J., ... Van Cutsem, G. (2013). High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa. <i>Southern African Journal of Hiv Medicine</i>, 14(4), 170 - 177. http://hdl.handle.net/11427/34825en_ZA
dc.identifier.chicagocitationGarone, D B, K Conradie, G Patten, M Cornell, W Goemaere, J Kunene, B Kerschberger, N Ford, A Boulle, and G Van Cutsem "High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa." <i>Southern African Journal of Hiv Medicine</i> 14, 4. (2013): 170 - 177. http://hdl.handle.net/11427/34825en_ZA
dc.identifier.citationGarone, D.B., Conradie, K., Patten, G., Cornell, M., Goemaere, W., Kunene, J., Kerschberger, B. & Ford, N. et al. 2013. High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa. <i>Southern African Journal of Hiv Medicine.</i> 14(4):170 - 177. http://hdl.handle.net/11427/34825en_ZA
dc.identifier.issn1608-9693
dc.identifier.issn2078-6751
dc.identifier.ris TY - Journal Article AU - Garone, D B AU - Conradie, K AU - Patten, G AU - Cornell, M AU - Goemaere, W AU - Kunene, J AU - Kerschberger, B AU - Ford, N AU - Boulle, A AU - Van Cutsem, G AB - Objective. To describe and evaluate the outcomes of a support programme for patients with virological failure while receiving second-line antiretroviral therapy (ART) in South Africa.Method. We described a comprehensive medical and counselling patient support programme for patients receiving secondline ART and with two consecutive viral loads (VLs) >1 000 copies/ml. Patients with >3 months follow-up and at least one VL measurement after inclusion in the programme were eligible for analysis.Results. Of 69 patients enrolled in the programme, 40 had at least one follow-up VL and no known drug resistance at enrolment; 27 (68%) of these re-suppressed while remaining on second-line ART following enhanced adherence support. The majority (18/27; 67%) achieved re-suppression within the first 3 months in the programme. Five patients with diagnosed second-line drug resistance achieved viral re-suppression (<400 copies/ml) after being switched to third-line ART. Seven patients (7/40; 18%) did not achieve viral re-suppression after 9 months in the programme: 6 with known adherence problems (4 without drug resistance on genotype) and 1 with a VL <1 000 copies/ml. Overall, 3 patients (4%) died, 3 (4%) were lost to follow-up and 2 (3%) were transferred out.Conclusion. Our experience from a routine programme demonstrates that with targeted adherence support, the majority of patients who were viraemic while receiving second-line ART returned to an undetectable VL within 3 months. By increasing the time receiving second-line ART and decreasing the need for genotypes and/or third-line ART, this intervention may reduce costs. DA - 2013 DB - OpenUCT DP - University of Cape Town IS - 4 J1 - Southern African Journal of Hiv Medicine LK - https://open.uct.ac.za PY - 2013 SM - 1608-9693 SM - 2078-6751 T1 - High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa TI - High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa UR - http://hdl.handle.net/11427/34825 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34825
dc.identifier.vancouvercitationGarone DB, Conradie K, Patten G, Cornell M, Goemaere W, Kunene J, et al. High rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa. Southern African Journal of Hiv Medicine. 2013;14(4):170 - 177. http://hdl.handle.net/11427/34825.en_ZA
dc.language.isoeng
dc.publisher.departmentCentre for Infectious Disease Epidemiology and Research
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouthern African Journal of Hiv Medicine
dc.source.journalissue4
dc.source.journalvolume14
dc.source.pagination170 - 177
dc.source.urihttps://dx.doi.org/10.4102/sajhivmed.v14i4.52
dc.subject.othersecond-line ART
dc.subject.otherfailure
dc.subject.othervirological re-suppression
dc.subject.otherantiretroviral therapy
dc.titleHigh rate of virological re-suppression among patients failing second-line antiretroviral therapy following enhanced adherence support: A model of care in Khayelitsha, South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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