[MoPp0302] Are the early results reported from community antiretroviral programs in South Africa durable with increasing numbers and time?

3rd International AIDS Society Conference on HIV Pathogenesis and Treatment

Rio de Janeiro - July 24 - 27, 2005

ARE THE EARLY RESULTS REPORTED FROM COMMUNITY ANTIRETROVIRAL PROGRAMS IN SOUTH AFRICA DURABLE WITH INCREASING NUMBERS AND TIME?

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. MoPp0302

Bekker L.-G.¹, Orrell C.¹, Pitt J.¹, Abdullah F.², Wood R.¹
¹Desmond Tutu HIV Centre, Cape Town, South Africa, ²Provincial Administration of Western Cape, Cape Town, South Africa

INTRODUCTION: The South African government has undertaken to put 1.4 million HIV infected people onto antiretroviral treatment by 2008. Whilst early reports from the first community based projects have been promising, this study describes the results from two community projects In Cape Town, more than two years after commencement.

METHODS: Two antiretroviral clinics were initiated, one in Guguletu (2002) and the other in Masiphumelele (2004). Both communities are socioeconomically disadvantaged and have high HIV prevalence rates. The programs have similar staffing and monitoring systems. As in the South African national roll out plan, there are 2 drug schedules and a stipulated monitoring program. The adherence, retention, viral suppression, quality of life and survival data from both clinics were pooled and are reported here.

RESULTS: More than 1000 patients have been screened and 700 patients commenced on treatment. The longest follow up is 120 weeks. The cohort is young (mean: 34 years), predominantly women (76%) and have advanced disease (90% are WHO stage 3 or 4 and mean CD4 count 95 cells/ml). Adherence levels are well maintained (>95% of all doses taken on pill count returns), as are the viral suppression rates (94% have <400 copies /ml). 92% of the cohort are retained on treatment, with a death rate of 7% and voluntary withdrawal from treatment of 1%. Deaths occur mostly within the first 100 days of treatment and are mostly related to opportunistic infections. 99% of the cohort on treatment is still on the first regimen. 4% have undergone drug substitutions for side effects. Quality of life measurements continue to be maintained at levels expected in an uninfected control population.

CONCLUSIONS: This data is encouraging that despite increase in numbers and extended periods of follow up, the excellent results first reported from these community programs are maintained.

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Clinical | MoPp0302 | Linda-Gail Bekker
11.6 247 11.6 Morbidity/mortality in the era of HAART

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