development and validation of a composite programmatic assessment tool for hiv therapy开发和验证一个复合程序化的艾滋病毒治疗的评估工具.pdfVIP

Development and Validation of a Composite Programmatic Assessment Tool for HIV Therapy 1,2 3 1 1 1 1,4 Viviane D. Lima *, Adrian Le , Bohdan Nosyk , Rolando Barrios , Benita Yip , Robert S. Hogg , P. Richard Harrigan1,2, Julio S. G. Montaner1,2 1 British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, British Columbia, Canada, 2 Division of AIDS, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 3 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 4 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada Abstract Background: We developed and validated a new and simple metric, the Programmatic Compliance Score (PCS), based on the IAS-USA antiretroviral therapy management guidelines for HIV-infected adults, as a predictor of all-cause mortality, at a program-wide level. We hypothesized that non-compliance would be associated with the highest probability of mortality. Methods and Findings: 3543 antiretroviral-naive HIV-infected patients aged $19 years who initiated antiretroviral therapy between January 1, 2000 and August 31, 2009 in British Columbia (BC), Canada, were followed until August 31, 2010. The PCS is composed by six non-performance indicators based on the IAS-USA guidelines: (1) having ,3 CD4 count tests in the first year after starting antiretroviral therapy; (2) having ,3 plasma viral load tests in the first year after starting antiretroviral therapy; (3) not having drug resistance testing done prior to starting antiretroviral therapy; (4) starting on a non-recommended antiretroviral therapy regimen;