SidaSubSaharaV1, Main, Exploration, bibRecord, 005B24

Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia

Identifieur interne : 005B24 ( Main/Exploration ); précédent : 005B23; suivant : 005B25

Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia

Auteurs : Benjamin H. Chi [Zambie, États-Unis] ; Ronald A. Cantrell [Zambie, États-Unis] ; Isaac Zulu [Zambie] ; Lloyd B. Mulenga [Zambie] ; Jens W. Levy [Zambie, États-Unis] ; Bushimbwa C. Tambatamba [Zambie] ; Stewart Reid [Zambie, États-Unis] ; Albert Mwango [Zambie] ; Alwyn Mwinga [Zambie] ; Marc Bulterys [Zambie] ; Michael S. Saag [États-Unis] ; Jeffrey Sa Stringer [Zambie, États-Unis]

Source :

International journal of epidemiology [ 0300-5771 ] ; 2009.

RBID : Pascal:09-0311150

Descripteurs français

Pascal (Inist)
- SIDA, Observance thérapeutique, Antiviral, Antirétroviral, Pronostic, Evolution, Homme, Malade, Traitement, Zambie, Virus immunodéficience humaine, Adhérence, Médicament, Chimiothérapie, Mortalité, Epidémiologie, Survie, Santé publique.
Wicri :
- geographic : Zambie.
- topic : Homme, Médicament, Mortalité, Santé publique.

English descriptors

KwdEn :
- AIDS, Adhesion, Antiretroviral agent, Antiviral, Chemotherapy, Drug, Epidemiology, Evolution, Human, Human immunodeficiency virus, Mortality, Patient, Prognosis, Public health, Survival, Treatment, Treatment compliance, Zambia.

Abstract

Background High-level adherence to antiretroviral therapy (ART) is associated with favourable patient outcomes. In resource-constrained settings, however, there are few validated measures. We examined the correlation between clinical outcomes and the medication possession ratio (MPR), a pharmacy-based measure of adherence. Methods We analysed data from a large programmatic cohort across 18 primary care centres providing ART in Lusaka, Zambia. Patients were stratified into three categories based on MPR-calculated adherence over the first 12 months: optimal (≥95%), suboptimal (80-94%) and poor (<80%). Results Overall, 27115 treatment-naïve adults initiated and continued ART for ≥12 months: 17 060 (62.9%) demonstrated optimal adherence, 7682 (28.3%) had suboptimal adherence and 2373 (8.8%) had poor adherence. When compared with those with optimal adherence, post-12-month mortality risk was similar among patients with sub-optimal adherence [adjusted hazard ratio (AHR)=1.0; 95% CI: 0.9-1.2] but higher in patients with poor adherence (AHR=1.7; 95% CI: 1.4-2.2). Those <80% MPR also appeared to have an attenuated CD4 response at 18 months (185 cells/μl vs 217 cells/μl; P<0.001), 24 months (213 cells/μl vs 246 cells/μl; P<0.001), 30 months (226 cells/μl vs 261 cells/μl; P < 0.001) and 36 months (245 cells/μl vs 275 cells/μl; P<0.01) when compared with those above this threshold. Conclusions MPR was predictive of clinical outcomes and immunologic response in this large public sector antiretroviral treatment program. This marker may have a role in guiding programmatic monitoring and clinical care in resource-constrained settings.

Affiliations:

Links toward previous steps (curation, corpus...)

to stream PascalFrancis, to step Corpus: 000444
to stream PascalFrancis, to step Curation: 000519
to stream PascalFrancis, to step Checkpoint: 000387
to stream Main, to step Merge: 005C04
to stream Main, to step Curation: 005B24

Le document en format XML

<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia</title>
<author><name sortKey="Chi, Benjamin H" sort="Chi, Benjamin H" uniqKey="Chi B" first="Benjamin H." last="Chi">Benjamin H. Chi</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Cantrell, Ronald A" sort="Cantrell, Ronald A" uniqKey="Cantrell R" first="Ronald A." last="Cantrell">Ronald A. Cantrell</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zulu, Isaac" sort="Zulu, Isaac" uniqKey="Zulu I" first="Isaac" last="Zulu">Isaac Zulu</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>US Centers for Disease Control and Prevention Global AIDS Program</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>US Centers for Disease Control and Prevention Global AIDS Program</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>School of Medicine, University of Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Lusaka</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mulenga, Lloyd B" sort="Mulenga, Lloyd B" uniqKey="Mulenga L" first="Lloyd B." last="Mulenga">Lloyd B. Mulenga</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Levy, Jens W" sort="Levy, Jens W" uniqKey="Levy J" first="Jens W." last="Levy">Jens W. Levy</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tambatamba, Bushimbwa C" sort="Tambatamba, Bushimbwa C" uniqKey="Tambatamba B" first="Bushimbwa C." last="Tambatamba">Bushimbwa C. Tambatamba</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Lusaka Urban District Health Management Team, Zambian Ministry of Health</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Lusaka</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Reid, Stewart" sort="Reid, Stewart" uniqKey="Reid S" first="Stewart" last="Reid">Stewart Reid</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mwango, Albert" sort="Mwango, Albert" uniqKey="Mwango A" first="Albert" last="Mwango">Albert Mwango</name>
<affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Zambian Ministry of Health</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Zambian Ministry of Health</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mwinga, Alwyn" sort="Mwinga, Alwyn" uniqKey="Mwinga A" first="Alwyn" last="Mwinga">Alwyn Mwinga</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>US Centers for Disease Control and Prevention Global AIDS Program</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>US Centers for Disease Control and Prevention Global AIDS Program</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bulterys, Marc" sort="Bulterys, Marc" uniqKey="Bulterys M" first="Marc" last="Bulterys">Marc Bulterys</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>US Centers for Disease Control and Prevention Global AIDS Program</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>US Centers for Disease Control and Prevention Global AIDS Program</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Saag, Michael S" sort="Saag, Michael S" uniqKey="Saag M" first="Michael S." last="Saag">Michael S. Saag</name>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Stringer, Jeffrey Sa" sort="Stringer, Jeffrey Sa" uniqKey="Stringer J" first="Jeffrey Sa" last="Stringer">Jeffrey Sa Stringer</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">09-0311150</idno>
<date when="2009">2009</date>
<idno type="stanalyst">PASCAL 09-0311150 INIST</idno>
<idno type="RBID">Pascal:09-0311150</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">000444</idno>
<idno type="wicri:Area/PascalFrancis/Curation">000519</idno>
<idno type="wicri:Area/PascalFrancis/Checkpoint">000387</idno>
<idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000387</idno>
<idno type="wicri:doubleKey">0300-5771:2009:Chi B:adherence:to:first</idno>
<idno type="wicri:Area/Main/Merge">005C04</idno>
<idno type="wicri:Area/Main/Curation">005B24</idno>
<idno type="wicri:Area/Main/Exploration">005B24</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia</title>
<author><name sortKey="Chi, Benjamin H" sort="Chi, Benjamin H" uniqKey="Chi B" first="Benjamin H." last="Chi">Benjamin H. Chi</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Cantrell, Ronald A" sort="Cantrell, Ronald A" uniqKey="Cantrell R" first="Ronald A." last="Cantrell">Ronald A. Cantrell</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Zulu, Isaac" sort="Zulu, Isaac" uniqKey="Zulu I" first="Isaac" last="Zulu">Isaac Zulu</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>US Centers for Disease Control and Prevention Global AIDS Program</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>US Centers for Disease Control and Prevention Global AIDS Program</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>School of Medicine, University of Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Lusaka</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mulenga, Lloyd B" sort="Mulenga, Lloyd B" uniqKey="Mulenga L" first="Lloyd B." last="Mulenga">Lloyd B. Mulenga</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Levy, Jens W" sort="Levy, Jens W" uniqKey="Levy J" first="Jens W." last="Levy">Jens W. Levy</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Tambatamba, Bushimbwa C" sort="Tambatamba, Bushimbwa C" uniqKey="Tambatamba B" first="Bushimbwa C." last="Tambatamba">Bushimbwa C. Tambatamba</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Lusaka Urban District Health Management Team, Zambian Ministry of Health</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Lusaka</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Reid, Stewart" sort="Reid, Stewart" uniqKey="Reid S" first="Stewart" last="Reid">Stewart Reid</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mwango, Albert" sort="Mwango, Albert" uniqKey="Mwango A" first="Albert" last="Mwango">Albert Mwango</name>
<affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Zambian Ministry of Health</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Zambian Ministry of Health</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mwinga, Alwyn" sort="Mwinga, Alwyn" uniqKey="Mwinga A" first="Alwyn" last="Mwinga">Alwyn Mwinga</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>US Centers for Disease Control and Prevention Global AIDS Program</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>US Centers for Disease Control and Prevention Global AIDS Program</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bulterys, Marc" sort="Bulterys, Marc" uniqKey="Bulterys M" first="Marc" last="Bulterys">Marc Bulterys</name>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>US Centers for Disease Control and Prevention Global AIDS Program</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>3 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>US Centers for Disease Control and Prevention Global AIDS Program</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Saag, Michael S" sort="Saag, Michael S" uniqKey="Saag M" first="Michael S." last="Saag">Michael S. Saag</name>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Stringer, Jeffrey Sa" sort="Stringer, Jeffrey Sa" uniqKey="Stringer J" first="Jeffrey Sa" last="Stringer">Jeffrey Sa Stringer</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Centre for Infectious Disease Research in Zambia</s1>
<s2>Lusaka</s2>
<s3>ZMB</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Zambie</country>
<wicri:noRegion>Centre for Infectious Disease Research in Zambia</wicri:noRegion>
</affiliation>
<affiliation wicri:level="2"><inist:fA14 i1="02"><s1>School of Medicine and Public Health, University of Alabama</s1>
<s2>Birmingham, AL</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName><region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">International journal of epidemiology</title>
<title level="j" type="abbreviated">Int. j. epidemiol.</title>
<idno type="ISSN">0300-5771</idno>
<imprint><date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">International journal of epidemiology</title>
<title level="j" type="abbreviated">Int. j. epidemiol.</title>
<idno type="ISSN">0300-5771</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS</term>
<term>Adhesion</term>
<term>Antiretroviral agent</term>
<term>Antiviral</term>
<term>Chemotherapy</term>
<term>Drug</term>
<term>Epidemiology</term>
<term>Evolution</term>
<term>Human</term>
<term>Human immunodeficiency virus</term>
<term>Mortality</term>
<term>Patient</term>
<term>Prognosis</term>
<term>Public health</term>
<term>Survival</term>
<term>Treatment</term>
<term>Treatment compliance</term>
<term>Zambia</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>SIDA</term>
<term>Observance thérapeutique</term>
<term>Antiviral</term>
<term>Antirétroviral</term>
<term>Pronostic</term>
<term>Evolution</term>
<term>Homme</term>
<term>Malade</term>
<term>Traitement</term>
<term>Zambie</term>
<term>Virus immunodéficience humaine</term>
<term>Adhérence</term>
<term>Médicament</term>
<term>Chimiothérapie</term>
<term>Mortalité</term>
<term>Epidémiologie</term>
<term>Survie</term>
<term>Santé publique</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Zambie</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
<term>Médicament</term>
<term>Mortalité</term>
<term>Santé publique</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background High-level adherence to antiretroviral therapy (ART) is associated with favourable patient outcomes. In resource-constrained settings, however, there are few validated measures. We examined the correlation between clinical outcomes and the medication possession ratio (MPR), a pharmacy-based measure of adherence. Methods We analysed data from a large programmatic cohort across 18 primary care centres providing ART in Lusaka, Zambia. Patients were stratified into three categories based on MPR-calculated adherence over the first 12 months: optimal (≥95%), suboptimal (80-94%) and poor (<80%). Results Overall, 27115 treatment-naïve adults initiated and continued ART for ≥12 months: 17 060 (62.9%) demonstrated optimal adherence, 7682 (28.3%) had suboptimal adherence and 2373 (8.8%) had poor adherence. When compared with those with optimal adherence, post-12-month mortality risk was similar among patients with sub-optimal adherence [adjusted hazard ratio (AHR)=1.0; 95% CI: 0.9-1.2] but higher in patients with poor adherence (AHR=1.7; 95% CI: 1.4-2.2). Those <80% MPR also appeared to have an attenuated CD4 response at 18 months (185 cells/μl vs 217 cells/μl; P<0.001), 24 months (213 cells/μl vs 246 cells/μl; P<0.001), 30 months (226 cells/μl vs 261 cells/μl; P < 0.001) and 36 months (245 cells/μl vs 275 cells/μl; P<0.01) when compared with those above this threshold. Conclusions MPR was predictive of clinical outcomes and immunologic response in this large public sector antiretroviral treatment program. This marker may have a role in guiding programmatic monitoring and clinical care in resource-constrained settings.</div>
</front>
</TEI>
<affiliations><list><country><li>Zambie</li>
<li>États-Unis</li>
</country>
<region><li>Alabama</li>
</region>
</list>
<tree><country name="Zambie"><noRegion><name sortKey="Chi, Benjamin H" sort="Chi, Benjamin H" uniqKey="Chi B" first="Benjamin H." last="Chi">Benjamin H. Chi</name>
</noRegion>
<name sortKey="Bulterys, Marc" sort="Bulterys, Marc" uniqKey="Bulterys M" first="Marc" last="Bulterys">Marc Bulterys</name>
<name sortKey="Cantrell, Ronald A" sort="Cantrell, Ronald A" uniqKey="Cantrell R" first="Ronald A." last="Cantrell">Ronald A. Cantrell</name>
<name sortKey="Levy, Jens W" sort="Levy, Jens W" uniqKey="Levy J" first="Jens W." last="Levy">Jens W. Levy</name>
<name sortKey="Mulenga, Lloyd B" sort="Mulenga, Lloyd B" uniqKey="Mulenga L" first="Lloyd B." last="Mulenga">Lloyd B. Mulenga</name>
<name sortKey="Mwango, Albert" sort="Mwango, Albert" uniqKey="Mwango A" first="Albert" last="Mwango">Albert Mwango</name>
<name sortKey="Mwinga, Alwyn" sort="Mwinga, Alwyn" uniqKey="Mwinga A" first="Alwyn" last="Mwinga">Alwyn Mwinga</name>
<name sortKey="Reid, Stewart" sort="Reid, Stewart" uniqKey="Reid S" first="Stewart" last="Reid">Stewart Reid</name>
<name sortKey="Stringer, Jeffrey Sa" sort="Stringer, Jeffrey Sa" uniqKey="Stringer J" first="Jeffrey Sa" last="Stringer">Jeffrey Sa Stringer</name>
<name sortKey="Tambatamba, Bushimbwa C" sort="Tambatamba, Bushimbwa C" uniqKey="Tambatamba B" first="Bushimbwa C." last="Tambatamba">Bushimbwa C. Tambatamba</name>
<name sortKey="Zulu, Isaac" sort="Zulu, Isaac" uniqKey="Zulu I" first="Isaac" last="Zulu">Isaac Zulu</name>
<name sortKey="Zulu, Isaac" sort="Zulu, Isaac" uniqKey="Zulu I" first="Isaac" last="Zulu">Isaac Zulu</name>
</country>
<country name="États-Unis"><region name="Alabama"><name sortKey="Chi, Benjamin H" sort="Chi, Benjamin H" uniqKey="Chi B" first="Benjamin H." last="Chi">Benjamin H. Chi</name>
</region>
<name sortKey="Cantrell, Ronald A" sort="Cantrell, Ronald A" uniqKey="Cantrell R" first="Ronald A." last="Cantrell">Ronald A. Cantrell</name>
<name sortKey="Levy, Jens W" sort="Levy, Jens W" uniqKey="Levy J" first="Jens W." last="Levy">Jens W. Levy</name>
<name sortKey="Reid, Stewart" sort="Reid, Stewart" uniqKey="Reid S" first="Stewart" last="Reid">Stewart Reid</name>
<name sortKey="Saag, Michael S" sort="Saag, Michael S" uniqKey="Saag M" first="Michael S." last="Saag">Michael S. Saag</name>
<name sortKey="Stringer, Jeffrey Sa" sort="Stringer, Jeffrey Sa" uniqKey="Stringer J" first="Jeffrey Sa" last="Stringer">Jeffrey Sa Stringer</name>
</country>
</tree>
</affiliations>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Main/Exploration

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 005B24 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 005B24 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    SidaSubSaharaV1
   |flux=    Main
   |étape=   Exploration
   |type=    RBID
   |clé=     Pascal:09-0311150
   |texte=   Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia
}}

This area was generated with Dilib version V0.6.32.
Data generation: Mon Nov 13 19:31:10 2017. Site generation: Wed Mar 6 19:14:32 2024

	Le SIDA en Afrique subsaharienne (serveur d'exploration)
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Le SIDA en Afrique subsaharienne (serveur d'exploration)

Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia

Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri