High Level of Viral Suppression and Low Switch Rate to Second-Line Antiretroviral Therapy among HIV-Infected Adult Patients Followed over Five Years: Retrospective Analysis of the DART Trial

Cissy Kityo, Diana M Gibb, Charles F Gilks, Ruth L Goodall, Ivan Mambule, Pontiano Kaleebu, Deenan Pillay, Ronnie Kasirye, Peter Mugyenyi, A Sarah Walker, David T Dunn and on behalf of the DART Trial Team

PLOS ONE, 2014, vol. 9, issue 3, 1-7

Abstract: : In contrast to resource-rich countries, most HIV-infected patients in resource-limited countries receive treatment without virological monitoring. There are few long-term data, in this setting, on rates of viral suppression or switch to second-line antiretroviral therapy. The DART trial compared clinically driven monitoring (CDM) versus routine laboratory (CD4/haematology/biochemistry) and clinical monitoring (LCM) in HIV-infected adults initiating therapy. There was no virological monitoring in either study group during follow-up, but viral load was measured in Ugandan participants at trial closure. Two thousand three hundred and seventeen (2317) participants from this country initiated antiretroviral therapy with zidovudine/lamivudine plus tenofovir (n = 1717), abacavir (n = 300), or nevirapine (n = 300). Of 1896 (81.8%) participants who were alive and in follow-up at trial closure (median 5.1 years after therapy initiation), 1507 (79.5%) were on first-line and 389 (20.5%) on second-line antiretroviral therapy. The overall switch rate after the first year was 5.6 per 100 person-years; the rate was substantially higher in participants with low baseline CD4 counts (

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0090772

DOI: 10.1371/journal.pone.0090772

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