3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

RESPONSE TO ANTIRETROVIRAL THERAPY (ART) IN THE MTCT-PLUS INITIATIVE, A MULTI-COUNTRY HIV CARE AND TREATMENT PROGRAM IN RESOURCE-LIMITED COUNTRIES

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. MoPp0305

Toro P., Katyal M., Abrams E., Austin J., Day J., El-Sadr W., Nash D., Katyal M., Abrams E., Austin J., Day J., El-Sadr W., Nash D.
Columbia University, New York, United States of America

INTRODUCTION: Response to ART in adults enrolled in the MTCT-Plus Initiative, a comprehensive HIV care and treatment program for HIV+ pregnant and postpartum women, their partners, and children at sites in 8 countries in Sub-Saharan Africa and Thailand, was assessed.

METHODS: Demographic information, weight, and CD4+ count were assessed among 1,399 patients initiating ART. Linear regression was used to estimate the relationship between time since initiation of ART and outcomes (CD4+ count and weight [kg]). Among 328 patients with a CD4+ count and weight available at the time of ART initiation (± 6 weeks) and at 6 months follow-up (± 6 weeks), the change in CD4+ count and weight was estimated using pairwise comparisons.

RESULTS: Of 4532 adults enrolled through November 2004, 1408 (31.1%) have initiated ART. 1,399 patients with 3,090 CD4 counts and 10,697 weight measurements were eligible for analysis. Among these 1,399 patients, 1,058 (75.6%) were women, of whom 403 (38.1%) were pregnant when starting therapy. At time of ART initiation, the mean age was 31 yrs and WHO stage distribution was I= 509 (36.4%), II=383 (27.4%), III=426 (30.5%), IV=81 (5.8%). Among 1,399 patients, each 6 months ART was associated with +41 cells/mm³ change in CD4+ count (p<0.001) and +1.7 kg in body weight (p<0.001) (excluding pregnant women). After 6 months of ART, CD4+ and weight increases were greatest for patients in WHO stages III (change in CD4+: 53 cells/mm³, weight 2.6 kg) and IV (change in CD4+: 82 cells/mm³, weight 2.6 kg). In pairwise analysis (n=328), the mean change in CD4+ and body weight over the first 6 months on ART was 144 cells/mm³ (p<0.0001) and 2.5 kg (p<0.0001), respectively.

CONCLUSIONS: Adults enrolled in the MTCT-Plus Initiative from multiple sites in RLC have a favorable response to ART. Persons with more advanced disease had the greatest improvement on ART.

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Clinical | MoPp0305 | Patricia Toro
11.7 271 11.7 Operational research

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