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Predictors of attrition and immunological failure in HIV-1 patients on highly active antiretroviral therapy from different healthcare settings in mozambique

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dc.contributor.authorPalladino, Claudia
dc.contributor.authorBriz, Veronica
dc.contributor.authorBellón, José María
dc.contributor.authorBártolo, Inês
dc.contributor.authorCarvalho, Patrícia
dc.contributor.authorCamacho, Ricardo
dc.contributor.authorMuñoz-Fernández, M. Ángeles
dc.contributor.authorBastos, Rui
dc.contributor.authorManuel, Rolanda
dc.contributor.authorCasanovas, José
dc.contributor.authorTaveira, Nuno
dc.date.accessioned2023-08-24T12:52:15Z
dc.date.available2023-08-24T12:52:15Z
dc.date.issued2013
dc.date.updated2023-02-03T14:32:01Z
dc.description.abstractIn 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/µL 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.pt_PT
dc.description.sponsorshipThe Maputo HIV-1 Cohort (MHIVC) was supported by the Portuguese Fundação para a Ciência e Tecnologia (FCT) (PSIDA/ESP/49699 and PTDC/SAU-FAR/115290/2009) and the Collaborative HIV and Anti-HIV Drug Resistance Network (CHAIN), from the European Union. Claudia Palladino is currently supported by the Portuguese Fundação para a Ciência e Tecnologia (FCT) (SFRH/BPD/77448/2011) and was supported by The Spanish MICINN (Juan de la Cierva JCI-2009-05650) until March 2012. Verónica Briz is supported by the Spanish Fondo de Investigación Sanitaria (Sara Borrell CD09/00433). Inês Bártolo is supported by the Portuguese Fundação para a Ciência e Tecnologia (FCT) (SFRH/BPD/76225/2011). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPalladino C, Briz V, Bellón JM, Bártolo I, Carvalho P, Camacho R, et al. Predictors of attrition and immunological failure in hiv-1 patients on highly active antiretroviral therapy from different healthcare settings in mozambique. Landay A, editor. PLoS ONE [Internet]. 20 de dezembro de 2013;8(12):e82718. Disponível em: https://dx.plos.org/10.1371/journal.pone.0082718pt_PT
dc.identifier.doi10.1371/journal.pone.0082718pt_PT
dc.identifier.eid2-s2.0-84893370669
dc.identifier.slugcv-prod-1108457
dc.identifier.urihttp://hdl.handle.net/10451/58993
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherPlospt_PT
dc.relationInvestigation of the genetic diversity and drug susceptibility of HIV-1 in Maputo, Mozambique
dc.relationCollaborative HIV and Anti-HIV Drug Resistance Network
dc.relationEPIDEMIOLOGY, PATHOGENESIS AND DETERMINANTS OF HIV-1 TRANSMISSION AND DISEASE PROGRESSION IN THE ANGOLAN PERINATAL HIV COHORT APEHC
dc.relationDESENVOLVIMENTO DE NOVOS MICROBICIDAS PARA PREVENIR A INFECÇÃO POR VIH
dc.relation.publisherversionhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0082718pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.titlePredictors of attrition and immunological failure in HIV-1 patients on highly active antiretroviral therapy from different healthcare settings in mozambiquept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleInvestigation of the genetic diversity and drug susceptibility of HIV-1 in Maputo, Mozambique
oaire.awardTitleCollaborative HIV and Anti-HIV Drug Resistance Network
oaire.awardTitleEPIDEMIOLOGY, PATHOGENESIS AND DETERMINANTS OF HIV-1 TRANSMISSION AND DISEASE PROGRESSION IN THE ANGOLAN PERINATAL HIV COHORT APEHC
oaire.awardTitleDESENVOLVIMENTO DE NOVOS MICROBICIDAS PARA PREVENIR A INFECÇÃO POR VIH
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/PDCT/PSIDA%2FESP%2F49699%2F2003/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/3599-PPCDT/PTDC%2FSAU-FAR%2F115290%2F2009/PT
oaire.awardURIinfo:eu-repo/grantAgreement/EC/FP7/223131/EU
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/OE/SFRH%2FBPD%2F77448%2F2011/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT//SFRH%2FBPD%2F76225%2F2011/PT
oaire.citation.issue12pt_PT
oaire.citation.startPagee82718pt_PT
oaire.citation.titlePLoS ONEpt_PT
oaire.citation.volume8pt_PT
oaire.fundingStreamPDCT
oaire.fundingStream3599-PPCDT
oaire.fundingStreamFP7
oaire.fundingStreamOE
person.familyNamePalladino
person.familyNameBártolo
person.familyNameCamacho
person.familyNameTaveira
person.givenNameClaudia
person.givenNameInês
person.givenNameRicardo
person.givenNameNuno
person.identifier.ciencia-id721D-6851-20D5
person.identifier.ciencia-id661E-F5CB-F85A
person.identifier.ciencia-id7111-3383-A926
person.identifier.orcid0000-0002-8148-0928
person.identifier.orcid0000-0002-2022-8921
person.identifier.orcid0000-0002-9129-3237
person.identifier.orcid0000-0003-0176-5585
person.identifier.ridI-7629-2012
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameEuropean Commission
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.cv.cienciaid661E-F5CB-F85A | Inês Bártolo
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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