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Adherence to Drug-Refill Is a Useful Early Warning Indicator of Virologic and Immunologic Failure among HIV Patients on First-Line ART in South Africa

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  • Ziad El-Khatib
  • David Katzenstein
  • Gaetano Marrone
  • Fatima Laher
  • Lerato Mohapi
  • Max Petzold
  • Lynn Morris
  • Anna Mia Ekström

Abstract

Background: Affordable strategies to prevent treatment failure on first-line regimens among HIV patients are essential for the long-term success of antiretroviral therapy (ART) in sub-Saharan Africa. WHO recommends using routinely collected data such as adherence to drug-refill visits as early warning indicators. We examined the association between adherence to drug-refill visits and long-term virologic and immunologic failure among non-nucleoside reverse transcriptase inhibitor (NNRTI) recipients in South Africa. Methods: In 2008, 456 patients on NNRTI-based ART for a median of 44 months (range 12–99 months; 1,510 person-years) were enrolled in a retrospective cohort study in Soweto. Charts were reviewed for clinical characteristics before and during ART. Multivariable logistic regression and Kaplan-Meier survival analysis assessed associations with virologic (two repeated VL>50 copies/ml) and immunologic failure (as defined by WHO). Results: After a median of 15 months on ART, 19% (n = 88) and 19% (n = 87) had failed virologically and immunologically respectively. A cumulative adherence of

Suggested Citation

  • Ziad El-Khatib & David Katzenstein & Gaetano Marrone & Fatima Laher & Lerato Mohapi & Max Petzold & Lynn Morris & Anna Mia Ekström, 2011. "Adherence to Drug-Refill Is a Useful Early Warning Indicator of Virologic and Immunologic Failure among HIV Patients on First-Line ART in South Africa," PLOS ONE, Public Library of Science, vol. 6(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0017518
    DOI: 10.1371/journal.pone.0017518
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    Cited by:

    1. Loice Achieng & Helen Musangi & Sharon Ong'uti & Edwin Ombegoh & LeeAnn Bryant & Jonathan Mwiindi & Nathaniel Smith & Philip Keiser, 2012. "An Observational Cohort Comparison of Facilitators of Retention in Care and Adherence to Anti-Eetroviral Therapy at an HIV Treatment Center in Kenya," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-7, March.
    2. Loice Achieng & Helen Musangi & Katherine Billingsley & Sharon Onguit & Edwin Ombegoh & LeeAnn Bryant & Jonathan Mwiindi & Nathaniel Smith & Philip Keiser, 2013. "The Use of Pill Counts as a Facilitator of Adherence with Antiretroviral Therapy in Resource Limited Settings," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.

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