Predictors of long-term viral failure among ugandan children and adults treated with antiretroviral therapy

Moses R. Kamya, Harriet Mayanja-Kizza, Andrew Kambugu, Sabrina Bakeera-Kitaka, Fred Semitala, Patricia Mwebaze-Songa, Barbara Castelnuovo, Petra Schaefer, Lisa A. Spacek, Anne F. Gasasira, Elly Katabira, Robert Colebunders, Thomas C Quinn, Allan Ronald, David L Thomas, Adeodata Kekitiinwa

Research output: Contribution to journalArticle

Abstract

BACKGROUND: HIV RNA viral load testing is costly and is generally unavailable in resource-limited settings. We identified predictors of viral failure and documented genotypic mutations in a subset of patients with viral failure after 12 months on antiretroviral therapy (ART). METHODS: From April 2004 to June 2005, consecutive treatment-naive patients beginning ART at a university clinic in Uganda were enrolled. Clinical information, CD4 cell count, and HIV RNA level were collected at baseline and every 3 to 6 months. Independent predictors of viral failure were identified using multivariate logistic regression. Genotypic drug resistance for 8 patients with viral failure at 12 months was measured at baseline and at 6 and 12 months. RESULTS: Five hundred twenty-six adults and 250 children (0 to 18 years of age) were started on first-line ART regimens and followed for 12 months. Outcomes could not be assessed in 13% of patients (79 died and 21 were withdrawn). Children were almost twice as likely to have viral failure compared with adults (26% vs. 14%; P = 0.0001). In adults, the sole independent predictor of viral failure was treatment with stavudine (d4T)/lamivudine (3TC)/nevirapine (NVP) versus zidovudine (ZDV)/3TC/efavirenz (EFV) (odds ratio [OR] = 2.59, 95% confidence interval [CI]: 1.20 to 5.59). In children, independent predictors of viral failure included male gender (OR = 2.44, 95% CI: 1.20 to 4.93), baseline CD4%

Original languageEnglish (US)
Pages (from-to)187-193
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume46
Issue number2
DOIs
StatePublished - Oct 2007

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Lamivudine
efavirenz
Odds Ratio
HIV
RNA
Confidence Intervals
Stavudine
Nevirapine
Uganda
Zidovudine
Therapeutics
CD4 Lymphocyte Count
Viral Load
Treatment Failure
Drug Resistance
Logistic Models
Mutation

Keywords

  • Antiretroviral therapy
  • Predictors
  • Resource-limited settings
  • Viral failure

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Kamya, M. R., Mayanja-Kizza, H., Kambugu, A., Bakeera-Kitaka, S., Semitala, F., Mwebaze-Songa, P., ... Kekitiinwa, A. (2007). Predictors of long-term viral failure among ugandan children and adults treated with antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes, 46(2), 187-193. https://doi.org/10.1097/QAI.0b013e31814278c0

Predictors of long-term viral failure among ugandan children and adults treated with antiretroviral therapy. / Kamya, Moses R.; Mayanja-Kizza, Harriet; Kambugu, Andrew; Bakeera-Kitaka, Sabrina; Semitala, Fred; Mwebaze-Songa, Patricia; Castelnuovo, Barbara; Schaefer, Petra; Spacek, Lisa A.; Gasasira, Anne F.; Katabira, Elly; Colebunders, Robert; Quinn, Thomas C; Ronald, Allan; Thomas, David L; Kekitiinwa, Adeodata.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 46, No. 2, 10.2007, p. 187-193.

Research output: Contribution to journalArticle

Kamya, MR, Mayanja-Kizza, H, Kambugu, A, Bakeera-Kitaka, S, Semitala, F, Mwebaze-Songa, P, Castelnuovo, B, Schaefer, P, Spacek, LA, Gasasira, AF, Katabira, E, Colebunders, R, Quinn, TC, Ronald, A, Thomas, DL & Kekitiinwa, A 2007, 'Predictors of long-term viral failure among ugandan children and adults treated with antiretroviral therapy', Journal of Acquired Immune Deficiency Syndromes, vol. 46, no. 2, pp. 187-193. https://doi.org/10.1097/QAI.0b013e31814278c0
Kamya, Moses R. ; Mayanja-Kizza, Harriet ; Kambugu, Andrew ; Bakeera-Kitaka, Sabrina ; Semitala, Fred ; Mwebaze-Songa, Patricia ; Castelnuovo, Barbara ; Schaefer, Petra ; Spacek, Lisa A. ; Gasasira, Anne F. ; Katabira, Elly ; Colebunders, Robert ; Quinn, Thomas C ; Ronald, Allan ; Thomas, David L ; Kekitiinwa, Adeodata. / Predictors of long-term viral failure among ugandan children and adults treated with antiretroviral therapy. In: Journal of Acquired Immune Deficiency Syndromes. 2007 ; Vol. 46, No. 2. pp. 187-193.
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AU - Kamya, Moses R.

AU - Mayanja-Kizza, Harriet

AU - Kambugu, Andrew

AU - Bakeera-Kitaka, Sabrina

AU - Semitala, Fred

AU - Mwebaze-Songa, Patricia

AU - Castelnuovo, Barbara

AU - Schaefer, Petra

AU - Spacek, Lisa A.

AU - Gasasira, Anne F.

AU - Katabira, Elly

AU - Colebunders, Robert

AU - Quinn, Thomas C

AU - Ronald, Allan

AU - Thomas, David L

AU - Kekitiinwa, Adeodata

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