Treatment as prevention in resource-limited settings: is it feasible to maintain HIV viral load suppression over time?
| Autor: | Flavio Rotryng, Daniel Pryluka, Liliana Stern, Pablo Lapadula, Alberto Lambierto, Daniela Paz, María Eugenia Socías, Maira Medrano |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Anti-HIV Agents Population MEDLINE Argentina HIV Infections Drug resistance Microbiology Chemoprevention Cohort Studies Young Adult Virology Drug Resistance Viral medicine Humans Treatment Failure Young adult education Developing Countries Retrospective Studies education.field_of_study business.industry HIV Retrospective cohort study General Medicine Viral Load Treatment as prevention Infectious Diseases Immunology Parasitology Female business Viral load Cohort study |
| Zdroj: | Journal of infection in developing countries. 7(8) |
| ISSN: | 1972-2680 |
| Popis: | Introduction: Recently, there has been increasing interest in the role of “treatment as prevention” (TasP). Some of the questions regarding TasP strategies arise from the perceived difficulties in achieving and maintaining viral load (VL) suppression over time and the risk of emergence of viral resistance that could compromise future treatment options. This study was conducted to assess these questions in a resource-limited setting. Methodology: We performed a retrospective observational study of HIV-infected patients diagnosed in the pre-HAART era on follow-up at a private center from Buenos Aires, Argentina. Socio-demographic, clinical, and laboratory data were extracted from clinical charts. Analyses were performed to test for potential associations of selected variables with current virologic failure or use of third-line drugs. Results: Of 619 patients on follow-up, 82 (13.2%) were diagnosed in the pre-HAART era. At the time of our study, 79 (96.3%) patients were on HAART, with a median duration of 14 years (IQR 12–15) of therapy, and exposure to mono or dual nucleoside reverse transcriptase inhibitors regimens in 47.8% of cases. Sixty-nine patients (87.3%) had undetectable VL, 37 (46.8%) never presented virologic failure, and 19 (24.1%) experienced only one failure. Thirteen patients (16.5%) were receiving third-line ART regimens, with an average of 2.7-fold more virologic failures than those on first- or second-line regimens (p = 0.007). Conclusions: Maintaining viral load suppression over time in resource-limited-settings is feasible. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|