WorldHealthOrganizationSurveysofTransmittedandAcq:的世界卫生组织调查和采集传输.pptVIP

WorldHealthOrganizationSurveysofTransmittedandAcq:的世界卫生组织调查和采集传输.ppt

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* * * World Health Organization Surveys of Transmitted and Acquired HIV Drug Resistance in Resource Limited Settings CROI 2011 S Bertagnolio*, K Kelley*, A Saadani Hassani*, Y Obeng-Aduasare**, M Jordan*° *World Health Organization, HIV Department, Geneva **Dartmouth College, NH, USA °Tufts University School of Medicine, MA, USA Goal of the WHO HIVDR Surveillance Strategy Standardized survey methods Inform population-based selection of 1st and 2nd line ART regimens Support national programs in minimizing the emergence and transmission of HIVDR Gilks et al. Lancet, 2006 Elements of the WHO HIVDR Surveillance Strategy Monitoring HIVDR Early Warning Indicators * at ART sites Surveillance of acquired HIVDR Surveillance of transmitted HIVDR *Jordan et al. Poster # 626; Poster Discussion Weds 1 pm Surveys of Acquired HIVDR Objectives To describe HIVDR in cohorts at start and 12 months after ART initiation To estimate viral load suppression 12 months after ART initiation at the clinic level Use results for programmatic adjustments Populations starting 1st line ART at sentinel clinics (naive and ARV exposed) Surveys of Acquired HIVDR Using WHO Methods (Feb 2011) 15 surveys conducted in 15 clinics in 5 countries Burundi, India, Malawi, Mozambique, Nigeria ~140 na?ve or ARV exposed adults or pediatric patients consecutively initiating first-line ART enrolled in each clinic Total of 2,150 patients surveyed, when data from the 15 surveys are combined N=2,150 Patients starting ART 1,448 (67.3%) Patients retained in care and alive at 12 months 128 Patients with viral load 1,000 c/ml (10%); all genotyped 1,150 Patients with viral load 1,000 c/ml (90%) 309 (14.4%) Lost to follow up 191 (8.9%) Transfer out 169 (7.9%) Died 26 (1.2%) Unclassifiable 6 (0.3%) Stopped 1 (0.05%) Switched to second line ART 1,503 (70%) Genotyped before ART initiation Acquired HIVDR Surveys Combined Analysis 1,278 Pa

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