1. Patient-level outcomes and virologic suppression rates in HIV-infected patients receiving antiretroviral therapy in Rwanda.
- Author
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Riedel DJ, Stafford KA, Memiah P, Coker M, Baribwira C, Sebeza J, Karorero E, Nsanzimana S, Morales F, and Redfield RR
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, CD4 Lymphocyte Count, Cross-Sectional Studies, Female, HIV Infections virology, Humans, Male, Middle Aged, Retrospective Studies, Rwanda epidemiology, Treatment Outcome, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, HIV Infections drug therapy, Viral Load drug effects
- Abstract
The Rwanda national HIV program has been successful at scaling up antiretroviral therapy (ART) to achieve universal access. The AIDSRelief Model of Care focuses on four key principles: (1) earlier initiation of ART; (2) use of durable, highly-potent, and sequence-friendly first-line ART regimens; (3) early detection of treatment failure; and (4) provision of community-based care and support to ensure optimal adherence and follow up/engagement in care. We conducted a retrospective cohort study of randomly-selected HIV-infected patients at AIDSRelief-supported sites using a stratified, random sample of 583 adults (>15 years) who initiated ART from 30 June 2008 to 1 February 2010. At ART initiation, the median patient age was 38 years, and 67% were female. The baseline median CD4+ cell count was 309 cells/mm
3 . Overall virologic suppression was 91%. Married/ever married status (adjusted prevalence odds ratio [aPOR] 3.75, 95% confidence interval [CI] 1.30-10.78) and self-reported adherence ≥95% in the past month (aPOR 2.76, 95% CI 1.00-7.62) were significantly associated with viral suppression in the multivariable model. Excellent virologic outcomes were achieved in Rwandan AIDSRelief sites utilizing the AIDSRelief Model of Care during the scale-up of ART in the country.- Published
- 2018
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