One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients

. Objective.  To determine whether adherence to clinic visits early after initiation of highly active antiretroviral therapy (HAART) is predictive of long‐term clinical outcome. Design.  Observational cohort study. Setting.  A tertiary referral hospital. Subjects.  A total of 387 adult HIV patients...

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Veröffentlicht in:Journal of internal medicine 2007-03, Vol.261 (3), p.268-275
Hauptverfasser: Park, W. B., Choe, P. G., Kim, S.‐H., Jo, J. H., Bang, J. H., Kim, H. B., Kim, N. J., Oh, M., Choe, K. W.
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container_end_page 275
container_issue 3
container_start_page 268
container_title Journal of internal medicine
container_volume 261
creator Park, W. B.
Choe, P. G.
Kim, S.‐H.
Jo, J. H.
Bang, J. H.
Kim, H. B.
Kim, N. J.
Oh, M.
Choe, K. W.
description . Objective.  To determine whether adherence to clinic visits early after initiation of highly active antiretroviral therapy (HAART) is predictive of long‐term clinical outcome. Design.  Observational cohort study. Setting.  A tertiary referral hospital. Subjects.  A total of 387 adult HIV patients who were followed for at least 1 year after initiation of HAART between January 1998 and December 2004. Main outcome measurements.  The effect of 1‐year adherence to clinic visits on the occurrence of new AIDS‐defining illness or death was assessed using Kaplan–Meier survival estimates, and hazard ratios were estimated using Cox proportional hazards regression model. Results.  Multivariate analysis revealed that advanced clinical stage, fewer new drugs in HAART, and longer total elapsed time without clinical visits for 1 year after HAART were all significant risk factors for the occurrence of new AIDS‐defining illnesses or death. Compared with no missed visits, the hazard ratio adjusted by clinical stage and number of new drugs in HAART was 2.87 (95% confidence interval [CI], 1.34–6.16, P = 0.007) for one missed appointment, 4.37 (95% CI: 1.74–10.98, P = 0.002) for two, and 8.19 (95% CI: 2.95–22.78, P 
doi_str_mv 10.1111/j.1365-2796.2006.01762.x
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B. ; Choe, P. G. ; Kim, S.‐H. ; Jo, J. H. ; Bang, J. H. ; Kim, H. B. ; Kim, N. J. ; Oh, M. ; Choe, K. W.</creator><creatorcontrib>Park, W. B. ; Choe, P. G. ; Kim, S.‐H. ; Jo, J. H. ; Bang, J. H. ; Kim, H. B. ; Kim, N. J. ; Oh, M. ; Choe, K. W.</creatorcontrib><description>. Objective.  To determine whether adherence to clinic visits early after initiation of highly active antiretroviral therapy (HAART) is predictive of long‐term clinical outcome. Design.  Observational cohort study. Setting.  A tertiary referral hospital. Subjects.  A total of 387 adult HIV patients who were followed for at least 1 year after initiation of HAART between January 1998 and December 2004. Main outcome measurements.  The effect of 1‐year adherence to clinic visits on the occurrence of new AIDS‐defining illness or death was assessed using Kaplan–Meier survival estimates, and hazard ratios were estimated using Cox proportional hazards regression model. Results.  Multivariate analysis revealed that advanced clinical stage, fewer new drugs in HAART, and longer total elapsed time without clinical visits for 1 year after HAART were all significant risk factors for the occurrence of new AIDS‐defining illnesses or death. Compared with no missed visits, the hazard ratio adjusted by clinical stage and number of new drugs in HAART was 2.87 (95% confidence interval [CI], 1.34–6.16, P = 0.007) for one missed appointment, 4.37 (95% CI: 1.74–10.98, P = 0.002) for two, and 8.19 (95% CI: 2.95–22.78, P &lt; 0.001) for three or more. Conclusion.  Adherence to clinic visits early after initiation of HAART is an independent predictor for long‐term clinical progression in HIV patients.</description><identifier>ISSN: 0954-6820</identifier><identifier>EISSN: 1365-2796</identifier><identifier>DOI: 10.1111/j.1365-2796.2006.01762.x</identifier><identifier>PMID: 17305649</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; AIDS ; Ambulatory Care - psychology ; Ambulatory Care - statistics &amp; numerical data ; Anti-HIV Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Biological and medical sciences ; Cohort Studies ; compliance ; Female ; General aspects ; highly active antiretroviral therapy ; HIV ; HIV Infections - drug therapy ; HIV Infections - psychology ; Human immunodeficiency virus ; Humans ; Male ; Medical sciences ; Middle Aged ; outcome ; Patient Compliance - statistics &amp; numerical data ; Pharmacology. Drug treatments ; Regression Analysis ; Risk Factors ; Treatment Outcome</subject><ispartof>Journal of internal medicine, 2007-03, Vol.261 (3), p.268-275</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4792-5d12b4602536df525c8595c40e9b01cf7eb511b8957879081c7a0bed480dd0b83</citedby><cites>FETCH-LOGICAL-c4792-5d12b4602536df525c8595c40e9b01cf7eb511b8957879081c7a0bed480dd0b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2796.2006.01762.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2796.2006.01762.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,1428,27905,27906,45555,45556,46390,46814</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=18547721$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17305649$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, W. B.</creatorcontrib><creatorcontrib>Choe, P. G.</creatorcontrib><creatorcontrib>Kim, S.‐H.</creatorcontrib><creatorcontrib>Jo, J. H.</creatorcontrib><creatorcontrib>Bang, J. H.</creatorcontrib><creatorcontrib>Kim, H. B.</creatorcontrib><creatorcontrib>Kim, N. J.</creatorcontrib><creatorcontrib>Oh, M.</creatorcontrib><creatorcontrib>Choe, K. W.</creatorcontrib><title>One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients</title><title>Journal of internal medicine</title><addtitle>J Intern Med</addtitle><description>. Objective.  To determine whether adherence to clinic visits early after initiation of highly active antiretroviral therapy (HAART) is predictive of long‐term clinical outcome. Design.  Observational cohort study. Setting.  A tertiary referral hospital. Subjects.  A total of 387 adult HIV patients who were followed for at least 1 year after initiation of HAART between January 1998 and December 2004. Main outcome measurements.  The effect of 1‐year adherence to clinic visits on the occurrence of new AIDS‐defining illness or death was assessed using Kaplan–Meier survival estimates, and hazard ratios were estimated using Cox proportional hazards regression model. Results.  Multivariate analysis revealed that advanced clinical stage, fewer new drugs in HAART, and longer total elapsed time without clinical visits for 1 year after HAART were all significant risk factors for the occurrence of new AIDS‐defining illnesses or death. Compared with no missed visits, the hazard ratio adjusted by clinical stage and number of new drugs in HAART was 2.87 (95% confidence interval [CI], 1.34–6.16, P = 0.007) for one missed appointment, 4.37 (95% CI: 1.74–10.98, P = 0.002) for two, and 8.19 (95% CI: 2.95–22.78, P &lt; 0.001) for three or more. Conclusion.  Adherence to clinic visits early after initiation of HAART is an independent predictor for long‐term clinical progression in HIV patients.</description><subject>Adult</subject><subject>AIDS</subject><subject>Ambulatory Care - psychology</subject><subject>Ambulatory Care - statistics &amp; numerical data</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>compliance</subject><subject>Female</subject><subject>General aspects</subject><subject>highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - psychology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>outcome</subject><subject>Patient Compliance - statistics &amp; numerical data</subject><subject>Pharmacology. Drug treatments</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>0954-6820</issn><issn>1365-2796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9u1DAQhyMEotvCKyBf4JYwduI_4YCEKmgXFe0FuFqOM-l6lU2C7d02N8QT8Iw8CQkb0SP4Ykvz_WZG_pKEUMjodF7vMpoLnjJZiowBiAyoFCy7f5Ss_hYeJysoeZEKxeAsOQ9hB0BzEPA0OaMyBy6KcpX82HT46_vPEY0npt6ix84iiT2xreucJUcXXAzENBE92brbbTsSY6M7IjFddB6j74_Om5bEKWyG8Q0xZPBYOxt7T_pmaTQBg-9vPYZAXEeu11_JYKLDLoZnyZPGtAGfL_dF8uXD-8-X1-nN5mp9-e4mtYUsWcpryqpCAOO5qBvOuFW85LYALCugtpFYcUorVXKpZAmKWmmgwrpQUNdQqfwieXXqOy3y7YAh6r0LFtvWdNgfghYlsJwq8U-QQTHNKOkEqhNofR-Cx0YP3u2NHzUFPYvSOz370LMPPYvSf0Tp-yn6YplxqPZYPwQXMxPwcgFMmH6v8aazLjxwihdSsnmHtyfuzrU4_vcC-uNm_Wl-5r8BS1ew8Q</recordid><startdate>200703</startdate><enddate>200703</enddate><creator>Park, W. B.</creator><creator>Choe, P. G.</creator><creator>Kim, S.‐H.</creator><creator>Jo, J. H.</creator><creator>Bang, J. H.</creator><creator>Kim, H. B.</creator><creator>Kim, N. J.</creator><creator>Oh, M.</creator><creator>Choe, K. W.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200703</creationdate><title>One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients</title><author>Park, W. B. ; Choe, P. G. ; Kim, S.‐H. ; Jo, J. H. ; Bang, J. H. ; Kim, H. B. ; Kim, N. J. ; Oh, M. ; Choe, K. W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4792-5d12b4602536df525c8595c40e9b01cf7eb511b8957879081c7a0bed480dd0b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>AIDS</topic><topic>Ambulatory Care - psychology</topic><topic>Ambulatory Care - statistics &amp; numerical data</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>compliance</topic><topic>Female</topic><topic>General aspects</topic><topic>highly active antiretroviral therapy</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - psychology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>outcome</topic><topic>Patient Compliance - statistics &amp; numerical data</topic><topic>Pharmacology. Drug treatments</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, W. B.</creatorcontrib><creatorcontrib>Choe, P. G.</creatorcontrib><creatorcontrib>Kim, S.‐H.</creatorcontrib><creatorcontrib>Jo, J. H.</creatorcontrib><creatorcontrib>Bang, J. H.</creatorcontrib><creatorcontrib>Kim, H. B.</creatorcontrib><creatorcontrib>Kim, N. J.</creatorcontrib><creatorcontrib>Oh, M.</creatorcontrib><creatorcontrib>Choe, K. W.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, W. B.</au><au>Choe, P. G.</au><au>Kim, S.‐H.</au><au>Jo, J. H.</au><au>Bang, J. H.</au><au>Kim, H. B.</au><au>Kim, N. J.</au><au>Oh, M.</au><au>Choe, K. W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients</atitle><jtitle>Journal of internal medicine</jtitle><addtitle>J Intern Med</addtitle><date>2007-03</date><risdate>2007</risdate><volume>261</volume><issue>3</issue><spage>268</spage><epage>275</epage><pages>268-275</pages><issn>0954-6820</issn><eissn>1365-2796</eissn><abstract>. Objective.  To determine whether adherence to clinic visits early after initiation of highly active antiretroviral therapy (HAART) is predictive of long‐term clinical outcome. Design.  Observational cohort study. Setting.  A tertiary referral hospital. Subjects.  A total of 387 adult HIV patients who were followed for at least 1 year after initiation of HAART between January 1998 and December 2004. Main outcome measurements.  The effect of 1‐year adherence to clinic visits on the occurrence of new AIDS‐defining illness or death was assessed using Kaplan–Meier survival estimates, and hazard ratios were estimated using Cox proportional hazards regression model. Results.  Multivariate analysis revealed that advanced clinical stage, fewer new drugs in HAART, and longer total elapsed time without clinical visits for 1 year after HAART were all significant risk factors for the occurrence of new AIDS‐defining illnesses or death. Compared with no missed visits, the hazard ratio adjusted by clinical stage and number of new drugs in HAART was 2.87 (95% confidence interval [CI], 1.34–6.16, P = 0.007) for one missed appointment, 4.37 (95% CI: 1.74–10.98, P = 0.002) for two, and 8.19 (95% CI: 2.95–22.78, P &lt; 0.001) for three or more. Conclusion.  Adherence to clinic visits early after initiation of HAART is an independent predictor for long‐term clinical progression in HIV patients.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17305649</pmid><doi>10.1111/j.1365-2796.2006.01762.x</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; IngentaConnect Free/Open Access Journals; EZB-FREE-00999 freely available EZB journals
subjects Adult
AIDS
Ambulatory Care - psychology
Ambulatory Care - statistics & numerical data
Anti-HIV Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiretroviral Therapy, Highly Active
Antiviral agents
Biological and medical sciences
Cohort Studies
compliance
Female
General aspects
highly active antiretroviral therapy
HIV
HIV Infections - drug therapy
HIV Infections - psychology
Human immunodeficiency virus
Humans
Male
Medical sciences
Middle Aged
outcome
Patient Compliance - statistics & numerical data
Pharmacology. Drug treatments
Regression Analysis
Risk Factors
Treatment Outcome
title One‐year adherence to clinic visits after highly active antiretroviral therapy: a predictor of clinical progress in HIV patients
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