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Journal Article
|Research

Outcomes of a remote, decentralized health center-based HIV/AIDS antiretroviral program in Zambia, 2003 to 2007

Elema R, Mills C, Yun O, Lokuge K, Ssonko C, Nyirongo N, Mtonga V, Zulu H, Tu D, Verputten M, O'Brien DP
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Abstract
A cross-sectional study of patients living with HIV/ AIDS treated during 2003 to 2007 in decentralized, rural health centers in Zambia was performed to measure virological outcomes after 12 months of antiretroviral therapy and identify factors associated with virological failure. Data from 228 patients who started antiretroviral therapy >12 months prior were analyzed. In all, 93% received stavudine + lamivudine + nevirapine regimens, and median antiretroviral therapy duration was 23.5 months (interquartile range 20-28). Of the 205 patients tested for viral load, 177 (86%) had viral load <1000 copies/mL. Probability of developing virological failure (viral load >1000 copies/mL) was 8.9% at 24 months and 19.6% at 32 months. Predictors for virological failure were <100% adherence, body mass index <18.5 kg/m(2), and women <40 years old. Of those with virological failure who underwent 3 to 6 months of intensive adherence counseling, 45% obtained virological success. In a remote, resource-limited setting in decentralized health centers, virological and immunological assessments of patients on antiretroviral therapy >12 months showed that positive health outcomes are achievable.

Countries

Zambia

Subject Area

HIV/AIDS

Languages

English
DOI
10.1177/1545109709331472
Published Date
11 Feb 2009
PubMed ID
19211930
Journal
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)
Volume | Issue | Pages
Volume 8, Issue 1, Pages 60-7
Issue Date
2009-01-01
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Outcomes of a remote, decentralized health center-based HIV/AIDS antiretroviral program in Zambia, 2003 to 2007 | Journal Article / Research | MSF Science Portal