Incidence and Predictors of Death, Retention, and Switch to Second Line Regimens in Antiretroviral Treated Patients in Sub Saharan African Sites with Comprehensive Monitoring Availability

  • Palombi L
  • Marazzi M
  • Guidotti G
 et al. 
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Background. Antiretroviral treatment programs in sub-Saharan Africa have high rates of early mortality and loss to follow-up. Switching to second-line regimens is often delayed because of limited access to laboratory monitoring. Methods. Retrospective analysis was performed of a cohort of adults who initiated a standard first-line antiretroviral treatment at 5 public sector sites in 3 African countries. Monitoring included routine CD4 cell counts, human immunodeficiency virus RNA measures, and records of whether appointments were kept. Incidence and predictors of death, loss to follow-up, and switch to second-line regimens were analyzed by time-to-event approaches. Results. A total of 3749 patients were analyzed; at baseline, 37.1% were classified as having World Health Organization disease stage 3 or 4, and the median CD4 cell count was 192 cells/{micro}L. First-line regimens were nevirapine based in 96.5% of patients; 17.7% of patients attended

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  • Leonardo Palombi

  • Maria Cristina Marazzi

  • Giovanni Guidotti

  • Paola Germano

  • Ersilia Buonomo

  • Paola Scarcella

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