Frequency of HIV-1 viral load monitoring of patients initially successfully treated with combination antiretroviral therapy

Scientific paper - Original scientific paper

• Author: Vanja Romih
• Author: Snježana Židovec Lepej
• Author: Kornelija Gedike
• Author: Davorka Lukas
• Author: Josip Begovac
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

BACKGROUND: Although considered an essential tool for monitoring the effect of combination antiretroviral treatment (CART), HIV-1 RNA (viral load, VL) testing is greatly influenced by cost and availability of resources. ----- OBJECTIVES: To examine whether HIV infected patients who were initially successfully treated with CART have less frequent monitoring of VL over time and whether CART failure and other HIV-disease and sociodemographic characteristics are associated with less frequent VL testing. ----- METHODS: The study included patients who started CART in the period 1999-2004, were older than 18 years, CART naive, had two consecutive viral load measurements of <400 copies/ml after 5 months of treatment and had continuous CART during the first 15 months. The time between two consecutive visits (days) was the outcome and associated factors were assessed using linear mixed models. ----- RESULTS: We analyzed a total of 128 patients with 1683 visits through December 2009. CART failure was observed in 31 (24%) patients. When adjusted for the follow-up time, the mean interval between two consecutive VL tests taken in patients before CART failure (155.2 days) was almost identical to the interval taken in patients who did not fail CART (155.3 days). On multivariable analysis, we found that the adjusted estimated time between visits was 150.9 days before 2003 and 177.6 in 2008/2009. A longer time between visits was observed in seafarers compared to non-seafarers; the mean difference was 30.7 days (95% CI, 14.0 to 47.4; p<0.001); and in individuals who lived more than 160 kilometers from the HIV treatment center (mean difference, 16 days, p=0.010). ----- CONCLUSIONS: Less frequent monitoring of VL became common in recent years and was not associated with failure. We identified seafarers as a population with special needs for CART monitoring and delivery.

• Keywords (english): Adult; Anti-HIV Agents / therapeutic use; Croatia; Drug Monitoring / methods; Drug Therapy, Combination; Female; Follow-Up Studies; HIV Infections / drug therapy; HIV Infections / virology; Humans; Male; Middle Aged; Multivariate Analysis; Outcome Assessment, Health Care / methods; Time Factors; Viral Load
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: PLoS One
• Numbering: vol. 5, no. 11, e15051
• p-ISSN: 1932-6203
• DOI: https://doi.org/10.1371/journal.pone.0015051
• URN:NBN: urn:nbn:hr:105:247626
• Publication: 2010-11-24
• Document URL: https://doi.org/10.1371/journal.pone.0015051
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 11:57:37