scholarly journals 951. Weight Gain Associated With Antiretroviral Therapy

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S508-S508
Author(s):  
Yesha Patel ◽  
Sheila Okere ◽  
Mark Lustberg ◽  
Carlos Malvestutto
Keyword(s):  
Human Immunodeficiency Virus ◽  
Weight Gain ◽  
Antiretroviral Therapy ◽  
Weight Change ◽  
Panel Member ◽  
Male Gender ◽  
Review Panel ◽  
Factors Associated ◽  
Immunodeficiency Virus

Abstract Background Obesity is a global public health crisis with a growing prevalence in persons with human immunodeficiency virus (PWH) population. In this study, we aimed to investigate factors associated with weight gain in the PWH population. Methods This was a single-centered, retrospective cohort study of our clinic patient population from January 1, 2015 to January 1, 2019. Patients with human immunodeficiency virus (HIV) were identified from the electronic health record and a randomized sample of 300 patients who had at least two follow up appointments, were on antiretroviral therapy, and had viral loads less than 200 were evaluated. The primary outcome was weight change over follow up. Cox Proportional Hazards models were used, taking a weight gain > 3 kg as the outcome, and the time on therapy between visits as the time to event. Robust linear regression was used to model mean changes in weight, accounting for influential observations. All analysis were performed in STATA 16.0. Table 1 Results At baseline, 87% were male, 63% were white, and 65% were overweight/obese. 30% were on a protease inhibitor, 46% were on non-nucleoside reverse transcriptase inhibitor, and 37% were on an integrase inhibitor. 64% were on Tenofovir disoproxil (TDF), 8% were on Tenofovir alafenamide (TAF), and 19% were on Abacavir. Mean weight change over follow up was significantly increased at 1.31 kg (95% CI = 0.58 – 2.04 kg, p= 0.0004). TAF use and male gender were significantly associated with risk of weight gain > 3 kg in univariate analysis [respectively, OR = 2.53, 95% CI = 1.30 – 4.92, p = 0.006; OR = 2.60, 95% CI = 1.05 – 6.45, p = 0.04]. In multivariate analysis, TAF use was significantly associated with weight gain > 3 kg, while male gender was of borderline significance [respectively, OR = 2.29, 95% CI = 1.17 – 4.47, p = 0.01; OR = 2.40, 95% CI = 0.96 – 5.97, p=0.060]. Significant factors associated with weight change are noted in Table 1. Conclusion As PWH are living longer on effective ARV therapy, monitoring for weight gain is required as obesity contributes to morbidity and mortality from cardiovascular disease and metabolic diseases. Key factors for weight gain in our clinic population include male gender, baseline diagnosis of hypertension, use of TAF, bictegravir use, and rilpivirine use. Disclosures Carlos Malvestutto, MD, Gilead Sciences (Advisor or Review Panel member)ViiV Healthcare (Advisor or Review Panel member)

scholarly journals Risk of Incident Diabetes Mellitus, Weight Gain, and Their Relationships With Integrase Inhibitor–Based Initial Antiretroviral Therapy Among Persons With Human Immunodeficiency Virus in the United States and Canada

2020 ◽  
Author(s):  
Peter F Rebeiro ◽  
Cathy A Jenkins ◽  
Aihua Bian ◽  
Jordan E Lake ◽  
Kassem Bourgi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Human Immunodeficiency Virus ◽  
Weight Gain ◽  
Antiretroviral Therapy ◽  
Cox Regression ◽  
The United States ◽  
Cart Regimen ◽  
Immunodeficiency Virus ◽  
The Impact

Abstract Background Integrase strand transfer inhibitor (INSTI)–based combination antiretroviral therapy (cART) is associated with greater weight gain among persons with human immunodeficiency virus (HIV), though metabolic consequences, such as diabetes mellitus (DM), are unclear. We examined the impact of initial cART regimen and weight on incident DM in a large North American HIV cohort (NA-ACCORD). Methods cART-naive adults (≥18 years) initiating INSTI-, protease inhibitor (PI)–, or nonnucleoside reverse transcriptase inhibitor (NNRTI)–based regimens from January 2007 through December 2017 who had weight measured 12 (±6) months after treatment initiation contributed time until clinical DM, virologic failure, cART regimen switch, administrative close, death, or loss to follow-up. Multivariable Cox regression yielded adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident DM by cART class. Mediation analyses, with 12-month weight as mediator, similarly adjusted for all covariates. Results Among 22 884 eligible individuals, 47% started NNRTI-, 30% PI-, and 23% INSTI-based cART with median follow-up of 3.0, 2.3, and 1.6 years, respectively. Overall, 722 (3%) developed DM. Persons starting INSTIs vs NNRTIs had incident DM risk (HR, 1.17 [95% CI, .92–1.48]), similar to PI vs NNRTI initiators (HR, 1.27 [95% CI, 1.07–1.51]). This effect was most pronounced for raltegravir (HR, 1.42 [95% CI, 1.06–1.91]) vs NNRTI initiators. The INSTI–DM association was attenuated (HR, 1.03 [95% CI, .71–1.49] vs NNRTIs) when accounting for 12-month weight. Conclusions Initiating first cART regimens with INSTIs or PIs vs NNRTIs may confer greater risk of DM, likely mediated through weight gain.

scholarly journals Safety, Tolerability, and Efficacy of Generic Dolutegravir-containing Antiretroviral Therapy Regimens Among South Indian Human Immunodeficiency Virus-infected Patients

2018 ◽  
Vol 68 (6) ◽  
pp. 1048-1051 ◽  
Author(s):  
Nagalingeswaran Kumarasamy ◽  
Sandeep Prabhu ◽  
Ezhilarasi Chandrasekaran ◽  
Selvamuthu Poongulali ◽  
Amrose Pradeep ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Prospective Cohort ◽  
Large Scale ◽  
First Line ◽  
South Indian ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Immunodeficiency Virus

AbstractIn this first study of generic dolutegravir (DTG)-containing regimens in a low-resource setting, we assessed safety, tolerability, and efficacy within a prospective cohort of 564 patients with at least 6 months of clinical follow-up. We provide support for a large-scale transition to DTG as part of first-line regimens.

scholarly journals Association of Hepatitis B Core-Related Antigen and Antihepatitis B Core Antibody With Liver Fibrosis Evolution in Human Immunodeficiency Virus-Hepatitis B Virus Coinfected Patients During Treatment With Tenofovir

2020 ◽  
Vol 7 (7) ◽  
Author(s):  
Romuald Cruchet ◽  
Lorenza N C Dezanet ◽  
Sarah Maylin ◽  
Audrey Gabassi ◽  
Hayette Rougier ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis B Virus ◽  
Antiretroviral Therapy ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Advanced Fibrosis ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Fibrosis Regression

Abstract Background Quantitative hepatitis B core-related antigen (qHBcrAg) or antihepatitis B core antibody (qAnti-HBc) could be useful in monitoring liver fibrosis evolution during chronic hepatitis B virus (HBV) infection, yet it has not been assessed in human immunodeficiency virus (HIV)-HBV-coinfected patients undergoing treatment with tenofovir (TDF). Methods One hundred fifty-four HIV-HBV-infected patients initiating a TDF-containing antiretroviral regimen were prospectively followed. The qHBcrAg and qAnti-HBc and liver fibrosis assessment were collected every 6–12 months during TDF. Hazard ratios (HRs) assessing the association between qHBcrAg/qAnti-HBc and transitions from none/mild/significant fibrosis to advanced fibrosis/cirrhosis (progression) and from advanced fibrosis/cirrhosis to none/mild/significant fibrosis (regression) were estimated using a time-homogeneous Markov model. Results At baseline, advanced liver fibrosis/cirrhosis was observed in 40 (26%) patients. During a median follow-up of 48 months (interquartile range, 31–90), 38 transitions of progression (IR = 7/100 person-years) and 34 transitions of regression (IR = 6/100 person-years) were observed. Baseline levels of qHBcrAg and qAnti-HBc were not associated with liver fibrosis progression (adjusted-HR per log10 U/mL = 1.07, 95% confidence interval [CI] = 0.93–1.24; adjusted-HR per log10 Paul-Ehrlich-Institute [PEI] U/mL = 0.85, 95% CI = 0.70–1.04, respectively) or regression (adjusted-HR per log10 U/mL = 1.17, 95% CI = 0.95–1.46; adjusted-HR per log10 PEI U/mL = 0.97, 95% CI = 0.78–1.22, respectively) after adjusting for age, gender, duration of antiretroviral therapy, protease inhibitor-containing antiretroviral therapy, and CD4+/CD8+ ratio. Nevertheless, changes from the previous visit of qAnti-HBc levels were associated with liver fibrosis regression (adjusted-HR per log10 PEIU/mL change = 5.46, 95% CI = 1.56–19.16). Conclusions Baseline qHBcrAg and qAnti-HBc levels are not associated with liver fibrosis evolution in TDF-treated HIV-HBV coinfected patients. The link between changes in qAnti-HBc levels during follow-up and liver fibrosis regression merits further study.

scholarly journals Risk factors for loss to follow-up in human immunodeficiency virus care in the Greater Accra Regional Hospital in Ghana: a retrospective cohort study

2019 ◽  
Vol 11 (6) ◽  
pp. 605-612
Author(s):  
Jerry S Sifa ◽  
Stephen Manortey ◽  
Sharon Talboys ◽  
Gloria A Ansa ◽  
Ekua E Houphouet
Keyword(s):  
Human Immunodeficiency Virus ◽  
Immune Deficiency Syndrome ◽  
Disease Status ◽  
Control Programme ◽  
Regional Hospital ◽  
Loss To Follow Up ◽  
Factors Associated ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus

Abstract Background Loss of human immunodeficiency virus (HIV)-positive patients to follow-up increases HIV-related morbidity and mortality. This study identified the factors associated with loss to follow-up (LTFU) in an urban health facility in Ghana. Methods A 12-y retrospective study was conducted using routinely collected data from the National Acquired Immune Deficiency Syndrome (AIDS) Control Programme (NACP) on persons living with HIV/AIDS (PLWHA) who initiated antiretroviral therapy (ART) from 2006 to 2017 at the Greater Accra Regional Hospital. Convenience sampling was used to select the study area. All gathered data were exported to Stata 14 statistical software for analysis. Results A total of 4330 PLWHA initiated ART between January 2006 and December 2017. Of these, 1166 (26.9%) were lost to follow-up over the 12-y period. The factors associated with LTFU included being a Muslim (adjusted hazard ratio [aHR] 1.31 [95% confidence interval {CI} 1.05 to 1.65]), having CD4 <250 cells/ml (aHR 1.45 [95% CI 1.21 to 1.76]) and completing adherence counselling (aHR 1.58 [95% CI 1.31 to 1.92]). Having other sources of health care funding and disclosure of one’s disease status were found to be protective (aHR 0.74 [95% CI 0.58 to 0.94] and 0.80 [95% CI 0.65 to 0.98], respectively). Conclusions Some of the determinants of LTFU in the hospital are comparable to those found in other parts of Africa and could be addressed using existing interventions.

scholarly journals Quantitation of Human Immunodeficiency Virus Type 1 DNA Forms with the Second Template Switch in Peripheral Blood Cells Predicts Disease Progression Independently of Plasma RNA Load

2002 ◽  
Vol 76 (20) ◽  
pp. 10099-10108 ◽  
Author(s):  
Leondios G. Kostrikis ◽  
Giota Touloumi ◽  
Rose Karanicolas ◽  
Nikos Pantazis ◽  
Cleo Anastassopoulou ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Clinical Outcome ◽  
Peripheral Blood ◽  
Combination Antiretroviral Therapy ◽  
Immunodeficiency Virus ◽  
Template Switch ◽  
Hiv 1

ABSTRACT There are several forms of human immunodeficiency virus type 1 (HIV-1) DNA in peripheral blood T cells and lymph nodes in untreated HIV-1-infected individuals and in patients whose plasma HIV-1 RNA levels are suppressed by long-term combination antiretroviral therapy. However, it remains to be established whether the concentration of HIV-1 DNA in cells predicts the clinical outcome of HIV-1 infection. In this report, we measured the concentration of HIV-1 DNA forms which has undergone the second template switch (STS DNA) and 2-long-terminal-repeat DNA circles in peripheral blood mononuclear cell (PBMC) samples. To do this, we used molecular-beacon-based real-time PCR assays and studied 130 patients with hemophilia in the Multicenter Hemophilia Cohort Study. We assessed the influence of baseline HIV-1 STS DNA levels on the progression of HIV-1 disease in the absence of combination antiretroviral therapy by Kaplan-Meier and Cox regression analysis. Among the patients who progressed to AIDS, the median levels (interquartile ranges) of STS HIV-1 DNA in PBMC were significantly higher than those of patients who remained AIDS free during the 16 years of follow-up (1,017 [235 to 6,059] and 286 [31 to 732] copies per 106 PBMC, respectively; P < 0.0001). Rates of progression to death and development of AIDS varied significantly (log rank P < 0.001) by quartile distribution of HIV-1 STS DNA levels. After adjustment for age at seroconversion, baseline CD4+ T-cell counts, plasma viral load, and T-cell-receptor excision circles, the relative hazards (RH) of death and AIDS were significantly increased with higher HIV-1 STS DNA levels (adjusted RH, 1.84 [95% confidence interval {CI}, 1.30 to 2.59] and 2.62 [95% CI, 1.75 to 3.93] per 10-fold increase per 106 PBMC, respectively). HIV-1 STS DNA levels in each individual remained steady in longitudinal PBMC samples during 16 years of follow-up. Our findings show that the concentration of HIV-1 STS DNA in PBMC complements the HIV-1 RNA load in plasma in predicting the clinical outcome of HIV-1 disease. This parameter may have important implications for understanding the virological response to combination antiretroviral therapy.

scholarly journals Incidence and Predictors of Lost to Follow up Among Children Attending ART Clinic at Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Tiruye Menshaw ◽  
Shiferaw Birhanu ◽  
Aklilu Endalamaw ◽  
Tigist Gébermaryam
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Retrospective Cohort ◽  
World Health ◽  
Loss To Follow Up ◽  
Immunodeficiency Virus ◽  
Health Organization ◽  
Dessie Referral Hospital

Abstract Background: Despite, antiretroviral therapy could reduce the transmission of human immunodeficiency virus and related morbidity, loss to follow up is a main challenge among children living with human immunodeficiency virus. Therefore, the aim of this study was to assess the incidence and predictors of loss to follow up among under 15 years old children attending antiretroviral therapy clinic at Dessie referral hospital, North east Ethiopia.Methods: A ten-year institution based retrospective cohort study was employed among 448 under 15 years’ old children who were enrolled on antiretroviral therapy. Data were entered and cleared using Epi- data version 3.1 and then exported to STATA version 14 for further statistical analysis. Kaplan Meier survival curve was used to estimate the survival time and log rank test was used to compare the survival time between different categories of the explanatory variables. Multivariable Cox proportional hazards model was fitted to identify predictors of loss to follow up and p-value < 0.05 was considered as statically significant.Results: The overall incidence rate of loss to follow up was 6.3 per100 children in years of observation. Being male (AHR=2.1, CI =1.37 ,3.34), age 1-5 years (AHR=1.6, CI=1.05,2.46), poor adherence to antiretroviral therapy (AHR = 6.6; CI=4.11,10.66), fair adherence to antiretroviral therapy (AHR= 2.2; CI = 1.13 ,4.20), regimen was not changed (AHR = 4.1; CI = 2.59 ,6.45), world health organization stage III and IV (AHR= 2.2; CI =1.40, 3.33) and height for age < -2 z score (AHR = 2.2; CI = 1.43, 3.44) were predictors of loss to follow up.Conclusion: The incidence rate of loss to follow was high. Age 1-5 years, world health organization stage III and IV, poor and fair adherence to antiretroviral therapy, regimen was not changed, being male and stunted were higher risk for loss to follow up. Therefore, close monitoring to the higher risk groups for loss to follow up highlighted in this study could decrease the rate of loss to follow up. Improving the adherence of children to antiretroviral therapy and nutritional support for stunted children were also recommended.

scholarly journals 828. Short- and Long-Term Metabolic Changes in Virologically Suppressed Patients Switching from TDF to TAF Containing Antiretroviral Therapy

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S506-S507
Author(s):  
Jason J Schafer ◽  
Matty Zimmerman ◽  
Ciara E Walshe ◽  
Jessie Cerankowski ◽  
Ayako Shimada ◽  
...  
Keyword(s):  
Weight Gain ◽  
Antiretroviral Therapy ◽  
Linear Model ◽  
Univariate Analysis ◽  
Panel Member ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Review Panel ◽  
Ascvd Risk ◽  
Research Grant

Abstract Background Switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) containing antiretroviral therapy (ART) may negatively influence weight, cholesterol, and atherosclerotic cardiovascular disease (ASCVD) risk. The timing, duration, and extent of these changes and their definitive associations with TAF remain unclear. Methods This retrospective observational study evaluated weight, body mass index (BMI), cholesterol, and ASCVD risk score changes in virologically suppressed patients living with HIV infection (PLWH) who switched from TDF to TAF without switching any other ART regimen components. Adult patients on TDF and no HIV viral load values &gt; 200 copies/mL for ≥ 2 years prior to and following a TAF switch were included. Body weight, BMI, cholesterol and other variables were collected for the 2 years before and after the switch. The Wilcoxon signed-rank test compared median values for each measurement pre and post switch in a univariate analysis. Longitudinal linear mixed effects models evaluated changes for each outcome measure at 1 and 2 years after the switch. Models were built with random effects for patients and included covariates such as time on TAF, age, sex, race, time with HIV, diabetes, smoking status, and concomitant medications associated with weight gain or loss. Results A total of 86 patients met study criteria (table 1). In the univariate analysis, there were significant increases in weight, BMI, total cholesterol, LDL, HDL, triglycerides, and ASCVD risk scores 2 years after switching to TAF (each p ≤ 0.05, table 2). However, after controlling for covariates, only the increases in total and LDL cholesterol were associated with switching to TAF and significantly different from expected changes predicted in the linear model. In terms of weight gain with TAF, patients gained an average of 4.3 pounds in year 1 and 3.8 pounds in year 2 after the switch. Neither of these increases were statistically different from the expected changes in weight predicted in the linear model (3.1 pounds/year, 95% CI: 1.6-4.6). Conclusion Despite observing significant increases in weight, BMI, cholesterol and ASCVD risk scores after switching to TAF, only the changes in cholesterol were significantly associated with TAF and different from changes expected in PLWH over time. Disclosures Jason J. Schafer, PharmD, MPH, Gilead (Research Grant or Support)Merck (Advisor or Review Panel member, Research Grant or Support)ViiV (Advisor or Review Panel member)

scholarly journals Analysis of viral load change in Case of HIV/AIDS Patients under ART Follow-up in Arba Minch General Hospital

2021 ◽  
Author(s):  
Markos Erango ◽  
Kabtamu Gergiso ◽  
Sultan Hebo
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
General Hospital ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Adherence Level ◽  
Immunodeficiency Virus ◽  
Over Time

Abstract Background: Monitoring human immunodeficiency virus plasma viral load over time is critical to identify virologic treatment failure in patients taking antiretroviral therapy. The aim of this study was to determine whether the overtime viral load changes depends on patient characteristic measured at baseline of human immunodeficiency virus patients at Arba Minch General Hospital.Methods: This prospective follow up study was conducted using data obtained from medical records, patient interviews, and laboratory workup for six months. The study was employed among 152 adult patients that were selected by systematic random sampling. Longitudinal data analysis that accounts for the correlated nature of the data handled through linear mixed effect models were used to fit the data set in this study.Result: The mean viral load declines over time for each of the adherence level groups. The estimates of linear (p = 0.0006) and quadratic visit time (p=0.0256) effects and the baseline characteristics sex, age, adherence level, and Isoniazid preventive therapy had significant effects on change of viral load of patients over time. Conclusion: In order to improve the status of the patient’s viral load over time, considering the patients’ differences in adherence to antiretroviral therapy, sex, age, and Isoniazid preventive therapy are important.

scholarly journals Faktor-Faktor yang Berhubungan dengan Tertundanya Inisiasi Terapi Antiretroviral pada Pasien dengan Infeksi Human Immunodeficiency Virus

2017 ◽  
Vol 3 (3) ◽  
pp. 151
Author(s):  
Dwi Rahayu NLP ◽  
Teguh H Karjadi ◽  
Erni J Nelwan ◽  
C Martin Rumende
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Functional Status ◽  
Opportunistic Infection ◽  
Clinical Stage ◽  
Bivariate Analysis ◽  
Hiv Patients ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
Delayed Initiation

Pendahuluan. Cakupan pemberian obat antiretroviral (ARV) yang semakin luas berdampak positif dengan menurunnya angka kematian dan kesakitan pasien Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS). Waktu inisiasi terapi ARV pada pasien HIV juga berhubungan erat dengan penurunan angka kematian dan kesakitan. Tertundanya inisiasi terapi ARV pada pasien HIV menyebabkan angka kematian yang lebih tinggi, yaitu sekitar 10% dibanding yang tidak tertunda. Penelitian ini bertujuan agar dapat dilakukan upaya pengendalian terhadap faktor-faktor tersebut sehingga menurunkan angka kesakitan dan kematian pada pasien HIV.Metode. Penelitian ini merupakan studi potong lintang pada pasien HIV rawat jalan dewasa di Rumah Sakit dr. Cipto Mangunkusumo (RSCM), Jakarta pada pasien yang memulai ARV pertama kali selama periode Januari 2013-Desember 2014. Data didapatkan dari rekam medis pasien. Tertundanya inisiasi terapi ARV dinyatakan bila pasien belum memulai terapi ARV 10 minggu setelah diagnosis HIV. Faktor-faktor yang diteliti adalah jenis kelamin, status pernikahan, tingkat pendidikan, pekerjaan, indeks massa tubuh, status fungsional, stadium klinis HIV dan infeksi oportunistik. Uji regresi logistik digunakan untuk mengetahui hubungan faktor-faktor tersebut dengan tertundanya inisiasi terapi ARV.Hasil. Berdasarkan hasil consecutive total sampling didapatkan 444 pasien yang memulai terapi ARV pertama kali, 107 pasien (24,1%) diketahui tertunda inisiasi terapi ARV dan 337 pasien (75,9%) tidak tertunda. Berdasarkan hasil analisis bivariat didapatkan 3 variabel yang memiliki kemaknaan statistik yaitu stadium klinis lanjut, status fungsional rendah dan adanya infeksi oportunistik dengan nilai p masing-masing yaitu <0,001). Pada analisis multivariat lebih lanjut terdapat dua variabel yang berhubungan dengan tertundanya inisiasi terapi ARV pada pasien HIV yaitu stadium klinis lanjut (OR: 2,92, IK95% 1,53- 7,40, p=0,02) dan adanya infeksi oportunistik (OR 1,99, IK95% 1,21-3,29, p=0,01).Simpulan. Stadium klinis lanjut dan adanya infeksi oportunistik merupakan faktor-faktor yang berhubungan dengan tertundanya inisiasi terapi ARV pada pasien HIV.Kata Kunci: tertundanya inisiasi ARV, faktor yang berhubungan, HIV/AIDSFactors Related to Delayed Antiretroviral Therapy Initiation in HIV PatientsIntroduction. Increase access towards antiretroviral therapy (ART) contribute to global decrease of HIV-associated morbidity and mortality. Time to initiation of ART in eligible HIV-infected patients is associated with reduction in mortality and morbidity. Delayed initiation of antiretroviral therapy can lead to increased of mortality rate more than 10% compare to early initiation. Methods. This study was a cross sectional study among adult HIV patients in Out-patient Clinic of HIV Integrated Clinic Cipto Mangunkusumo General Hospital who started ARV therapy for the first time (ART-naïve patients) enrolled from January 2013 to December 2014. The data were extracted from medical records to identify factors associated with delayed initiation ART among HIV patient. Delayed initiation ART was defined as eligible patients didn’t initiate ART within 10 weeks after the diagnosis of HIV infection. Factors identified were gender, education level, employment, marital status, WHO clinical stage, BMI, functional status, and the presence of opportunistic infection. Logistic regression test was used to find factors associated with delayed initiation of ART. Results. There were 444 subjects in this study, which consisted of 107 patients (24.1%) who delayed initiation of ART and 337 patients (75.9%) who didn’t delayed initiation of ART. Based on the bivariate analysis, there were three variables statistically significance, which were advanced WHO clinical stage (p<0.001), lower functional status (p<0.001) and the presence of opportunistic infection (p<0.001). Further multivariate analysis showed that there were two variables associated with delayed initiation of ART, which were advanced WHO clinical stage (OR: 2.92, 95%CI 1.53-7.40, p=0.02) and the presence of opportunistic infection (OR 1.99, 95%CI 1.21-3.29, p=0.01). Conclusions. Advanced WHO clinical stage and the presence of opportunistic infections are factors associated with delayed initiation of ART among HIV patients. Keywords: delayed initiation of antiretroviral therapy, factors associated, HIV/AIDS

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