原创力文档second-line antiretroviral therapy in a workplace and community-based treatment programme in south africa determinants of virological outcome二线抗逆转录病毒疗法在工作场所和社区治疗项目在南非病毒学的决定因素的结果.pdfVIP
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second-line antiretroviral therapy in a workplace and community-based treatment programme in south africa determinants of virological outcome二线抗逆转录病毒疗法在工作场所和社区治疗项目在南非病毒学的决定因素的结果
Second-Line Antiretroviral Therapy in a Workplace and
Community-Based Treatment Programme in South
Africa: Determinants of Virological Outcome
1 2 3 3
Victoria Johnston *, Katherine Fielding , Salome Charalambous , Mildred Mampho ,
1,3,4 5 1
Gavin Churchyard , Andrew Phillips , Alison D. Grant
1 Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Department of Infectious Diseases Epidemiology,
London School of Hygiene and Tropical Medicine, London, United Kingdom, 3 Department of Research, The Aurum Institute, Johannesburg, South Africa, 4 Centre for the
AIDS Programme of Research in South Africa, University of KwaZulu Natal, Durban, South Africa, 5 Department of Infection and Population Health, University College
London, London, United Kingdom
Abstract
Background: As antiretroviral treatment (ART) programmes in resource-limited settings mature, more patients are
experiencing virological failure. Without resistance testing, deciding who should switch to second-line ART can be difficult.
The consequences for second-line outcomes are unclear. In a workplace- and community-based multi-site programme, with
6-monthly virological monitoring, we describe outcomes and predictors of viral suppression on second-line, protease
inhibitor-based ART.
Methods: We used prospectively collected clinic data from patients commencing first-line ART between 1/1/03 and 31/12/
08 to construct a study cohort of patients switched to second-line ART in the presence of a viral load (VL) $400 copies/ml.
Predictors of VL,400 copies/ml within 15 months of switch were assessed using modifi
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