scholarly journals Do Sex and Race/Ethnicity Influence CD4 Cell Response in Patients Who Achieve Virologic Suppression during Antiretroviral Therapy?

2003 ◽  
Vol 37 (3) ◽  
pp. 433-437 ◽  
Author(s):  
T. P. Giordano ◽  
J. A. Wright ◽  
M. Q. Hasan ◽  
A. C. White ◽  
E. A. Graviss ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Response ◽  
Virologic Suppression ◽  
Race Ethnicity ◽  
Cd4 Cell

scholarly journals Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Priya Bhagwat ◽  
Shashi N Kapadia ◽  
Heather J Ribaudo ◽  
Roy M Gulick ◽  
Judith S Currier
Keyword(s):  
Antiretroviral Therapy ◽  
Adverse Events ◽  
Socioeconomic Factors ◽  
Ethnic Groups ◽  
Virologic Failure ◽  
Virologic Suppression ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

Patient-level outcomes and virologic suppression rates in HIV-infected patients receiving antiretroviral therapy in Rwanda

2018 ◽  
Vol 29 (9) ◽  
pp. 861-872
Author(s):  
David J Riedel ◽  
Kristen A Stafford ◽  
Peter Memiah ◽  
Modupe Coker ◽  
Cyprien Baribwira ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Universal Access ◽  
Scale Up ◽  
Virologic Suppression ◽  
Model Of Care ◽  
Prevalence Odds Ratio ◽  
Cd4 Cell Count ◽  
Art Initiation ◽  
Care And Support ◽  
Cd4 Cell

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/mm3. 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.

scholarly journals Changing mortality risk associated with CD4 cell response to antiretroviral therapy in South Africa

AIDS ◽  
2009 ◽  
Vol 23 (3) ◽  
pp. 335-342 ◽  
Author(s):  
Stephen D Lawn ◽  
Francesca Little ◽  
Linda-Gail Bekker ◽  
Richard Kaplan ◽  
Elizabeth Campbel ◽  
...  
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Mortality Risk ◽  
Cell Response ◽  
Cd4 Cell
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