Monitoring of HIV treatment in seven countries in the WHO Region of the Americas

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dc.contributor.authorBelaunzarán-Zamudio, Pablo
dc.contributor.authorCaro-Vega, Yanink
dc.contributor.authorShepherd, Bryan E
dc.contributor.authorCrabtree-Ramirez, Brenda
dc.contributor.authorLuz, Paula
dc.contributor.authorGrinsztejn, Beatriz
dc.contributor.authorCesar, Carina
dc.contributor.authorCahn, Pedro
dc.contributor.authorCortes, Claudia
dc.contributor.authorWolff, Marcelo
dc.contributor.authorPape, Jean W
dc.contributor.authorPadgett, Denis
dc.contributor.authorGotuzzo, Eduardo
dc.contributor.authorMcGowan, Catherine
dc.contributor.authorSierra Madero, Juan
dc.contributor.authorCCASAnet
dc.date.accessioned2024-05-23T10:10:10Z
dc.date.available2024-05-23T10:10:10Z
dc.date.issued2015-8
dc.description.abstractObjective: To determine the prevalence of adequate monitoring and the costs of measuring CD4+ T-lymphocytes (CD4+ cell) and human immunodeficiency virus (HIV) viral load in people receiving antiretroviral therapy (ART) in seven countries in the WHO Region of the Americas. Methods: We obtained retrospective, longitudinal data for 14 476 adults who started a first ART regimen at seven HIV clinics in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru between 2000 and 2011. We estimated the proportion of 180-day periods with adequate monitoring, which we defined as at least one CD4+ cell count and one viral load measurement. Factors associated with adequate monitoring were analysed using regression methods. The costs of the tests were estimated. Findings: The median follow-up time was 50.4 months; the proportion of 180-day periods with adequate CD4+ cell counts was 69% while the proportion with adequate monitoring was 62%. Adequate monitoring was more likely in participants who were older, who started ART more recently, whose first regimen included a non-nucleoside reverse transcriptase inhibitor or who had a CD4+ cell count less than 200 cells/µl at ART initiation. The cost of one CD4+ cell count ranged from 7.37 United States dollars (US$) in Argentina to US$ 64.09 in Chile; the cost of one viral load measurement ranged from US$ 20.34 in Brazil to US$ 186.28 in Haiti. Conclusion: In HIV-infected participants receiving ART in the WHO Region of the Americas, CD4+ cell count and viral load monitoring was often carried out less frequently than regional guidelines recommend. The laboratory costs of monitoring varied greatly.
dc.identifier.citationBelaunzarán-Zamudio, P. F., Caro-Vega, Y., Shepherd, B. E., Crabtree-Ramirez, B., Luz, P. M., Grinsztejn, B., ... Sierra Madero, J. G.; CCASAnet. (2015). Monitoring of HIV treatment in seven countries in the WHO Region of the Americas. Bulletin of the World Health Organization, 93(8), 529-39. doi:10.2471/BLT.14.147447.
dc.identifier.otherDOI: 10.2471/BLT.14.147447
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1036
dc.relation.ispartofseriesBulletin of the World Health Organization, 93(8)
dc.subjectHIV Treatment
dc.subjectMonitoring
dc.subjectWHO Region
dc.titleMonitoring of HIV treatment in seven countries in the WHO Region of the Americas

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