Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort

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dc.contributor.authorFord, Nathanen_ZA
dc.contributor.authorDarder, Martaen_ZA
dc.contributor.authorSpelman, Timen_ZA
dc.contributor.authorMaclean, Emien_ZA
dc.contributor.authorMills, Edwarden_ZA
dc.contributor.authorBoulle, Andrewen_ZA
dc.date.accessioned2015-11-16T04:08:03Z
dc.date.available2015-11-16T04:08:03Z
dc.date.issued2010en_ZA
dc.description.abstractObjective Previous studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure. Design We assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five years of follow up and multivariate analysis used to model associations of baseline variables and medication adherence with time to viral suppression or failure. RESULTS: Our adherence cohort comprised 207 patients, among whom 72% were female. Median age was 30 years and median CD4 count at initiation was 55 cells/mm 3 . We found no statistically significant differences between baseline characteristics and early adherence groups. Multivariate analysis adjusting for baseline CD4 and age found that patients with suboptimal baseline adherence had a hazard ratio of 2.82 (95% CI 1.19-6.66, p = 0.018) for progression to virological failure compared to those whose baseline adherence was considered optimal. CONCLUSIONS: Our longitudinal study provides further confirmation of adherence as a primary determinant of subsequent confirmed virological failure, and serves as a reminder of the importance of initial early investments in adherence counseling and support as an effective way to maximize long-term treatment success.en_ZA
dc.identifier.apacitationFord, N., Darder, M., Spelman, T., Maclean, E., Mills, E., & Boulle, A. (2010). Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort. <i>PLoS One</i>, http://hdl.handle.net/11427/14986en_ZA
dc.identifier.chicagocitationFord, Nathan, Marta Darder, Tim Spelman, Emi Maclean, Edward Mills, and Andrew Boulle "Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort." <i>PLoS One</i> (2010) http://hdl.handle.net/11427/14986en_ZA
dc.identifier.citationFord, N., Darder, M., Spelman, T., Maclean, E., Mills, E., & Boulle, A. (2010). Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort. PLoS One, 5(5), e10460. doi:10.1371/journal.pone.0010460en_ZA
dc.identifier.ris TY - Journal Article AU - Ford, Nathan AU - Darder, Marta AU - Spelman, Tim AU - Maclean, Emi AU - Mills, Edward AU - Boulle, Andrew AB - Objective Previous studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure. Design We assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five years of follow up and multivariate analysis used to model associations of baseline variables and medication adherence with time to viral suppression or failure. RESULTS: Our adherence cohort comprised 207 patients, among whom 72% were female. Median age was 30 years and median CD4 count at initiation was 55 cells/mm 3 . We found no statistically significant differences between baseline characteristics and early adherence groups. Multivariate analysis adjusting for baseline CD4 and age found that patients with suboptimal baseline adherence had a hazard ratio of 2.82 (95% CI 1.19-6.66, p = 0.018) for progression to virological failure compared to those whose baseline adherence was considered optimal. CONCLUSIONS: Our longitudinal study provides further confirmation of adherence as a primary determinant of subsequent confirmed virological failure, and serves as a reminder of the importance of initial early investments in adherence counseling and support as an effective way to maximize long-term treatment success. DA - 2010 DB - OpenUCT DO - 10.1371/journal.pone.0010460 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort TI - Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort UR - http://hdl.handle.net/11427/14986 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14986
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0010460
dc.identifier.vancouvercitationFord N, Darder M, Spelman T, Maclean E, Mills E, Boulle A. Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort. PLoS One. 2010; http://hdl.handle.net/11427/14986.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2010 Ford et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherDrug adherenceen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherMultivariate analysisen_ZA
dc.subject.otherTuberculosisen_ZA
dc.titleEarly adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohorten_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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