New CDC studies point to better practices in timing, testing, and retention of patients in HIV anti-retroviral drug treatment (ART) in Africa
New collaborative studies being presented by the Centers for Disease Control and Prevention (CDC) at the XIX International AIDS Conference confirm early treatment of HIV patients results in better outcomes, suggest use of viral load testing to detect treatment failure, and highlight factors associated with low rate of ART enrollment.
CDC plays an essential role in implementing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through its scientific and technical expertise, and long-standing partnerships with Ministries of Health and other key global partners such as the World Health Organization. Presentations at the conference reflect CDC’s commitment to fighting global HIV/AIDS and to achieving President Obama and Secretary Clinton’s call to action to achieve an AIDS-free generation.
Late ART, early death in Malawi
A study conducted in Malawi by CDC and partners concluded that starting ART late was the main cause of early death in patients with advanced HIV disease. Early death was defined as death within the first three months of initiating ART. According to CDC’s Kundai Moyo, the research identifies a need for pre-ART care services to closely monitor HIV patients that do not yet qualify for ART.
Determinants of Mortality in a Cohort of Patients Initiating ART in Four Sites in Malawi. 23 July, 12:30 PM ET
Interventions to improve TB screening, begin appropriate therapy early, and retain patients in care needed in Kenya
CDC’s Surbhi Modi and colleagues conducted a retrospective cohort evaluation to describe programmatic practices related to TB screening and TB/HIV treatment among patients enrolled in HIV care and treatment in Nyanza Province, Kenya in 2009-2010. Despite a high rate of TB screening when enrolling in HIV care, TB diagnosis was lower than recent prospective studies suggest, and start of ART for patients with TB/HIV was often delayed. The authors point to the need for interventions to improve TB screening, begin appropriate therapy early, and retain patients in care.
Tuberculosis Screening and Management of HIV-infected Patients with TB, Nyanza Province, Kenya, July 2009-August 2010. 23 July, 12:30 PM ET.
Viral load testing plays a role in reducing mother-to-child transmission in women failing treatment in Kenya
Measuring viral load in women who become pregnant while on HIV treatment (ART) is useful in detecting those who are failing treatment, CDC researcher Lucy Nganga and colleagues report. The results have implications for making appropriate interventions to reduce mother to child HIV transmission.
Routine Viral Load Testing among Pregnant HIV-positive Women on ART: Implications for Prevention, Nyanza Province, Kenya 2011. 24 July, 1:00 pm ET
To lower attrition rate, determine ART eligibility at enrollment in Tanzania
In a Tanzania study, CDC’s Stephanie Kovacs and colleagues described the population of patients who are enrolled into pre-ART care programs in five regions of the country and their outcomes. They found that a large number of patients did not have their ART eligibility determined at enrollment. These patients dropped out of the program at high rates.
The Identification of High Levels of Loss to Follow-up (LTFU) Among Pre-ART Patients with Unknown ART Eligibility in Five Regions of Tanzania. 24 July, 12:30 PM ET
Factors associated with long-term retention of patients on ART in Kenya
A study led by CDC’s A. Waruru and colleagues examined data from clinical records of 1,676 patients, 15 years and older who initiated ART between February 2003 and February 2010 in an urban slum in Nairobi, Kenya. The findings identified several factors associated with loss to follow up: having TB at enrollment, a low CD4 cell count, and not having a baseline CD4 cell count. The study also underscores the need for early access to care as well as access to inexpensive point-of-care CD4 testing.
Long-term Retention and Predictors of Loss to Follow-up in an ART Program in an Urban Slum in Kenya. 24 July, 12:30 PM, ET
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