Determinants of sustained virological suppression in indigent, HIV-infected patients

Is single protease inhibitor-based antiretroviral therapy truly highly active?

Fehmida Visnegarwala, E. A. Graviss, P. Sajja, C. J. Lahart, A. Clinton White

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Effective virological suppression with HAART is dependent on strict adherence to therapy. Compliance with therapy is influenced by clinical and psychosocial factors. Method: We performed a retrospective study investigating determinants of effective virological suppression, defined as <400 RNA at 11-13 months of HAART, in an urban indigent population. The study included 366 new patients presenting for care to the Thomas Street Clinic, Houston, Texas, between April and December 1998. Median age, CD4 count, and viral load (VL) of the study population were 37.5 years, 189 cells/mm3, and 53,000, respectively. Thirty-nine percent had AIDS, 20% had cocaine-positive drug screens, and 64% were antiretroviral neïve. Two hundred and sixty-seven patients were started on HAART. Thirty-four percent showed virological suppression. Results: In multivariate analyst, adherence to HAART, care by experienced primary provider, baseline VL <100,000 copies/mL, age >35 years, and no active substance use were associated with virological suppression. Rates of virological suppression with HAART are unacceptably low in this urban indigent population. Conclusion: Low rates of virological suppression are primarily due to lack of adherence rather than late utilization of care among ethnic minorities. Single protease-inhibitor-based antiretroviral therapy does not appear to be highly active in this patent population.

Original languageEnglish (US)
Pages (from-to)117-124
Number of pages8
JournalHIV Clinical Trials
Volume5
Issue number3
DOIs
StatePublished - May 2004
Externally publishedYes

Fingerprint

Highly Active Antiretroviral Therapy
Poverty
Protease Inhibitors
HIV
Urban Population
Therapeutics
Retrospective Studies
Psychology
Population

Keywords

  • Adherence
  • HAART
  • HIV outcomes
  • Urban indigent

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Determinants of sustained virological suppression in indigent, HIV-infected patients : Is single protease inhibitor-based antiretroviral therapy truly highly active? / Visnegarwala, Fehmida; Graviss, E. A.; Sajja, P.; Lahart, C. J.; White, A. Clinton.

In: HIV Clinical Trials, Vol. 5, No. 3, 05.2004, p. 117-124.

Research output: Contribution to journalArticle

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