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Abstract(s)
"In Mozambique, the evaluation of retention in HIV care and ART programmes is limited. To assess rate and predictors of
attrition (no retention in care) and HAART effectiveness in HIV-1 infected patients who pay for medication and laboratory
testing in Mozambique, we conducted a multicenter survey of HIV-1-infected patients who started HAART during 2002–
2006. Cox proportional hazard models were used to assess risk of attrition and of therapy failure. Overall, 142 patients from
16 healthcare centers located in the capital city Maputo were followed-up for 22.2 months (12.1–46.7). The retention rate
was 75%, 48% and 37% after one, two and three years, respectively. Risk of attrition was lower in patients with higher
baseline CD4 count (P = 0.022) and attending healthcare center 1 (HCC1) (P = 0.013). The proportion of individuals with CD4
count #200 cells/mL was 55% (78/142) at baseline and decreased to 6% (3/52) at 36 months. Among the patients with
available VL, 86% (64/74) achieved undetectable VL levels. The rate of immunologic failure was 17.2% (95% CI: 12.6–22.9)
per 100 person-years. Risk of failure was associated to higher baseline CD4 count (P = 0.002), likely reflecting low adherence
levels, and decreased with baseline VL $10,000 copies/mL (P = 0.033). These results suggest that HAART can be effective in
HIV-1 infected patients from Mozambique that pay for their medication and laboratory testing. Further studies are required
to identify the causes for low retention rates in patients with low CD4 counts and to better understand the association
between healthcare setting and attrition rate."
Description
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Users must also make clear the license terms under which the work was published. CC BY Licence: http://creativecommons.org/licenses/by/4.0/
Keywords
Antiretroviral therapy HIV-1 Highly-active antiretroviral therapy Mozambique
Citation
PLoS ONE 8(12): e82718. doi:10.1371/journal.pone.0082718