Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD)
Objectives Surrogate markers of HIV disease progression are HIV RNA in plasma viral load (VL) and CD4 cell count (immune function). Despite improved international access to antiretrovirals, surrogate marker diagnostics are not routinely available in resource‐limited settings. Therefore, the objectiv...
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| creator | Oyomopito, R Lee, MP Phanuphak, P Lim, PL Ditangco, R Zhou, J Sirisanthana, T Chen, YMA Pujari, S Kumarasamy, N Sungkanuparph, S Lee, CKC Kamarulzaman, A Oka, S Zhang, FJ Mean, CV Merati, T Tau, G Smith, J Li, PCK |
| description | Objectives
Surrogate markers of HIV disease progression are HIV RNA in plasma viral load (VL) and CD4 cell count (immune function). Despite improved international access to antiretrovirals, surrogate marker diagnostics are not routinely available in resource‐limited settings. Therefore, the objective was to assess effects of economic and diagnostic resourcing on patient treatment outcomes.
Methods
Analyses were based on 2333 patients initiating highly active antiretroviral therapy (HAART) from 2000 onwards. Sites were categorized by World Bank country income criteria (high/low) and annual frequency of VL (≥3, 1–2 or |
| doi_str_mv | 10.1111/j.1468-1293.2010.00822.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2914850</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>754897183</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5042-d117220c6d607e12b40eedd83608e0064b9ca5d71e0a1fd4605deed76be975e73</originalsourceid><addsrcrecordid>eNqNUtFu0zAUjRCIjcEvIL-xSaTYjpM4EkKKtkEnDVWaAq-WE9-krpI42Em3fim_g9OWCp7AL74695xzfeUTBIjgBfHnw2ZBWMJDQrNoQbFHMeaULp6eBeenxvN9zUKaJPQseOXcBmOSRhl-GZxRHLGYc3Ie_PwK0k0WHDI1cnoE5Gsz2Ur3DRosKF2NaKutaU2jK-SmwYPOadO_R7rrpv7Y8OBgegdI9got774jpZ13Bu9hmqMC1aZtzePsvNbNut0hWY16O2tGbWG0xg-SLRrXYOWwQ5fLPH8orpDuZwgVD7d5gXKn5X7AqnRgt3L0xl5zI0dZzvMui3y5url6HbyoZevgzfG-CL59vi2ul-H96svddX4fVjFmNFSEpJTiKlEJToHQkmEApXiUYA4YJ6zMKhmrlACWpFYswbHyhDQpIUtjSKOL4NPBd5jKDlQF_ehXEIPVnbQ7YaQWf3d6vRaN2QqaEcZj7A3eHQ2s-TGBG0WnXQVtK3swkxNpzHiWEh79m-mJCeWEeSY_MCtrnLNQn95DsJgDJDZizomYcyLmAIl9gMSTl779c5-T8HdiPOHjgfCoW9j9t7HwX-aL6BdUv9k2</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>748962814</pqid></control><display><type>article</type><title>Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD)</title><source>MEDLINE</source><source>IngentaConnect Open Access Journals</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Oyomopito, R ; Lee, MP ; Phanuphak, P ; Lim, PL ; Ditangco, R ; Zhou, J ; Sirisanthana, T ; Chen, YMA ; Pujari, S ; Kumarasamy, N ; Sungkanuparph, S ; Lee, CKC ; Kamarulzaman, A ; Oka, S ; Zhang, FJ ; Mean, CV ; Merati, T ; Tau, G ; Smith, J ; Li, PCK</creator><creatorcontrib>Oyomopito, R ; Lee, MP ; Phanuphak, P ; Lim, PL ; Ditangco, R ; Zhou, J ; Sirisanthana, T ; Chen, YMA ; Pujari, S ; Kumarasamy, N ; Sungkanuparph, S ; Lee, CKC ; Kamarulzaman, A ; Oka, S ; Zhang, FJ ; Mean, CV ; Merati, T ; Tau, G ; Smith, J ; Li, PCK ; TREAT Asia HIV Observational Database ; on behalf of The TREAT Asia HIV Observational Database</creatorcontrib><description><![CDATA[Objectives
Surrogate markers of HIV disease progression are HIV RNA in plasma viral load (VL) and CD4 cell count (immune function). Despite improved international access to antiretrovirals, surrogate marker diagnostics are not routinely available in resource‐limited settings. Therefore, the objective was to assess effects of economic and diagnostic resourcing on patient treatment outcomes.
Methods
Analyses were based on 2333 patients initiating highly active antiretroviral therapy (HAART) from 2000 onwards. Sites were categorized by World Bank country income criteria (high/low) and annual frequency of VL (≥3, 1–2 or <1) or CD4 (≥3 or <3) testing. Endpoints were time to AIDS/death and change in CD4 cell count and VL suppression (<400 HIV‐1 RNA copies/mL) at 12 months. Demographics, Centers for Disease Control and Prevention (CDC) classification, baseline VL/CD4 cell counts, hepatitis B/C coinfections and HAART regimen were covariates. Time to AIDS/death was analysed by proportional hazards models. CD4 and VL endpoints were analysed using linear and logistic regression, respectively.
Results
Increased disease progression was associated with site‐reported VL testing less than once per year [hazard ratio (HR)=1.4; P=0.032], severely symptomatic HIV infection (HR=1.4; P=0.003) and hepatitis C virus coinfection (HR=1.8; P=0.011). A total of 1120 patients (48.2%) had change in CD4 cell count data. Smaller increases were associated with older age (P<0.001) and ‘Other’ HIV source exposures, including injecting drug use and blood products (P=0.043). A total of 785 patients (33.7%) contributed to the VL suppression analyses. Patients from sites with VL testing less than once per year [odds ratio (OR)=0.30; P<0.001] and reporting ‘Other’ HIV exposures experienced reduced suppression (OR=0.28; P<0.001).
Conclusion
Low measures of site resourcing were associated with less favourable patient outcomes, including a 35% increase in disease progression in patients from sites with VL testing less than once per year.]]></description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/j.1468-1293.2010.00822.x</identifier><identifier>PMID: 20345881</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Anti-Retroviral Agents - therapeutic use ; antiretroviral therapy ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Asia ; Asia - epidemiology ; CD4 antigen ; CD4 counts ; CD4 Lymphocyte Count - economics ; CD4 Lymphocyte Count - statistics & numerical data ; diagnostic monitoring ; Disease Progression ; Economics ; Female ; Health Services Accessibility - economics ; Healthcare Disparities - economics ; Hepatitis C - complications ; highly active antiretroviral therapy ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV Infections - virology ; HIV-1 ; Human immunodeficiency virus ; Humans ; Immune response ; Income ; Male ; Models, Statistical ; Outcome and Process Assessment, Health Care ; Prospective Studies ; RNA ; RNA, Viral - blood ; Time Factors ; viral load ; Viral Load - economics ; Viral Load - statistics & numerical data</subject><ispartof>HIV medicine, 2010-09, Vol.11 (8), p.519-529</ispartof><rights>2010 British HIV Association</rights><rights>2010 British HIV Association 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5042-d117220c6d607e12b40eedd83608e0064b9ca5d71e0a1fd4605deed76be975e73</citedby><cites>FETCH-LOGICAL-c5042-d117220c6d607e12b40eedd83608e0064b9ca5d71e0a1fd4605deed76be975e73</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.1468-1293.2010.00822.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1468-1293.2010.00822.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20345881$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oyomopito, R</creatorcontrib><creatorcontrib>Lee, MP</creatorcontrib><creatorcontrib>Phanuphak, P</creatorcontrib><creatorcontrib>Lim, PL</creatorcontrib><creatorcontrib>Ditangco, R</creatorcontrib><creatorcontrib>Zhou, J</creatorcontrib><creatorcontrib>Sirisanthana, T</creatorcontrib><creatorcontrib>Chen, YMA</creatorcontrib><creatorcontrib>Pujari, S</creatorcontrib><creatorcontrib>Kumarasamy, N</creatorcontrib><creatorcontrib>Sungkanuparph, S</creatorcontrib><creatorcontrib>Lee, CKC</creatorcontrib><creatorcontrib>Kamarulzaman, A</creatorcontrib><creatorcontrib>Oka, S</creatorcontrib><creatorcontrib>Zhang, FJ</creatorcontrib><creatorcontrib>Mean, CV</creatorcontrib><creatorcontrib>Merati, T</creatorcontrib><creatorcontrib>Tau, G</creatorcontrib><creatorcontrib>Smith, J</creatorcontrib><creatorcontrib>Li, PCK</creatorcontrib><creatorcontrib>TREAT Asia HIV Observational Database</creatorcontrib><creatorcontrib>on behalf of The TREAT Asia HIV Observational Database</creatorcontrib><title>Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD)</title><title>HIV medicine</title><addtitle>HIV Med</addtitle><description><![CDATA[Objectives
Surrogate markers of HIV disease progression are HIV RNA in plasma viral load (VL) and CD4 cell count (immune function). Despite improved international access to antiretrovirals, surrogate marker diagnostics are not routinely available in resource‐limited settings. Therefore, the objective was to assess effects of economic and diagnostic resourcing on patient treatment outcomes.
Methods
Analyses were based on 2333 patients initiating highly active antiretroviral therapy (HAART) from 2000 onwards. Sites were categorized by World Bank country income criteria (high/low) and annual frequency of VL (≥3, 1–2 or <1) or CD4 (≥3 or <3) testing. Endpoints were time to AIDS/death and change in CD4 cell count and VL suppression (<400 HIV‐1 RNA copies/mL) at 12 months. Demographics, Centers for Disease Control and Prevention (CDC) classification, baseline VL/CD4 cell counts, hepatitis B/C coinfections and HAART regimen were covariates. Time to AIDS/death was analysed by proportional hazards models. CD4 and VL endpoints were analysed using linear and logistic regression, respectively.
Results
Increased disease progression was associated with site‐reported VL testing less than once per year [hazard ratio (HR)=1.4; P=0.032], severely symptomatic HIV infection (HR=1.4; P=0.003) and hepatitis C virus coinfection (HR=1.8; P=0.011). A total of 1120 patients (48.2%) had change in CD4 cell count data. Smaller increases were associated with older age (P<0.001) and ‘Other’ HIV source exposures, including injecting drug use and blood products (P=0.043). A total of 785 patients (33.7%) contributed to the VL suppression analyses. Patients from sites with VL testing less than once per year [odds ratio (OR)=0.30; P<0.001] and reporting ‘Other’ HIV exposures experienced reduced suppression (OR=0.28; P<0.001).
Conclusion
Low measures of site resourcing were associated with less favourable patient outcomes, including a 35% increase in disease progression in patients from sites with VL testing less than once per year.]]></description><subject>Adult</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>antiretroviral therapy</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Asia</subject><subject>Asia - epidemiology</subject><subject>CD4 antigen</subject><subject>CD4 counts</subject><subject>CD4 Lymphocyte Count - economics</subject><subject>CD4 Lymphocyte Count - statistics & numerical data</subject><subject>diagnostic monitoring</subject><subject>Disease Progression</subject><subject>Economics</subject><subject>Female</subject><subject>Health Services Accessibility - economics</subject><subject>Healthcare Disparities - economics</subject><subject>Hepatitis C - complications</subject><subject>highly active antiretroviral therapy</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV Infections - virology</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immune response</subject><subject>Income</subject><subject>Male</subject><subject>Models, Statistical</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Prospective Studies</subject><subject>RNA</subject><subject>RNA, Viral - blood</subject><subject>Time Factors</subject><subject>viral load</subject><subject>Viral Load - economics</subject><subject>Viral Load - statistics & numerical data</subject><issn>1464-2662</issn><issn>1468-1293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUtFu0zAUjRCIjcEvIL-xSaTYjpM4EkKKtkEnDVWaAq-WE9-krpI42Em3fim_g9OWCp7AL74695xzfeUTBIjgBfHnw2ZBWMJDQrNoQbFHMeaULp6eBeenxvN9zUKaJPQseOXcBmOSRhl-GZxRHLGYc3Ie_PwK0k0WHDI1cnoE5Gsz2Ur3DRosKF2NaKutaU2jK-SmwYPOadO_R7rrpv7Y8OBgegdI9got774jpZ13Bu9hmqMC1aZtzePsvNbNut0hWY16O2tGbWG0xg-SLRrXYOWwQ5fLPH8orpDuZwgVD7d5gXKn5X7AqnRgt3L0xl5zI0dZzvMui3y5url6HbyoZevgzfG-CL59vi2ul-H96svddX4fVjFmNFSEpJTiKlEJToHQkmEApXiUYA4YJ6zMKhmrlACWpFYswbHyhDQpIUtjSKOL4NPBd5jKDlQF_ehXEIPVnbQ7YaQWf3d6vRaN2QqaEcZj7A3eHQ2s-TGBG0WnXQVtK3swkxNpzHiWEh79m-mJCeWEeSY_MCtrnLNQn95DsJgDJDZizomYcyLmAIl9gMSTl779c5-T8HdiPOHjgfCoW9j9t7HwX-aL6BdUv9k2</recordid><startdate>201009</startdate><enddate>201009</enddate><creator>Oyomopito, R</creator><creator>Lee, MP</creator><creator>Phanuphak, P</creator><creator>Lim, PL</creator><creator>Ditangco, R</creator><creator>Zhou, J</creator><creator>Sirisanthana, T</creator><creator>Chen, YMA</creator><creator>Pujari, S</creator><creator>Kumarasamy, N</creator><creator>Sungkanuparph, S</creator><creator>Lee, CKC</creator><creator>Kamarulzaman, A</creator><creator>Oka, S</creator><creator>Zhang, FJ</creator><creator>Mean, CV</creator><creator>Merati, T</creator><creator>Tau, G</creator><creator>Smith, J</creator><creator>Li, PCK</creator><general>Blackwell Publishing Ltd</general><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>7X8</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>201009</creationdate><title>Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD)</title><author>Oyomopito, R ; Lee, MP ; Phanuphak, P ; Lim, PL ; Ditangco, R ; Zhou, J ; Sirisanthana, T ; Chen, YMA ; Pujari, S ; Kumarasamy, N ; Sungkanuparph, S ; Lee, CKC ; Kamarulzaman, A ; Oka, S ; Zhang, FJ ; Mean, CV ; Merati, T ; Tau, G ; Smith, J ; Li, PCK</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5042-d117220c6d607e12b40eedd83608e0064b9ca5d71e0a1fd4605deed76be975e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>antiretroviral therapy</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Antiviral agents</topic><topic>Asia</topic><topic>Asia - epidemiology</topic><topic>CD4 antigen</topic><topic>CD4 counts</topic><topic>CD4 Lymphocyte Count - economics</topic><topic>CD4 Lymphocyte Count - statistics & numerical data</topic><topic>diagnostic monitoring</topic><topic>Disease Progression</topic><topic>Economics</topic><topic>Female</topic><topic>Health Services Accessibility - economics</topic><topic>Healthcare Disparities - economics</topic><topic>Hepatitis C - complications</topic><topic>highly active antiretroviral therapy</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>HIV Infections - virology</topic><topic>HIV-1</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immune response</topic><topic>Income</topic><topic>Male</topic><topic>Models, Statistical</topic><topic>Outcome and Process Assessment, Health Care</topic><topic>Prospective Studies</topic><topic>RNA</topic><topic>RNA, Viral - blood</topic><topic>Time Factors</topic><topic>viral load</topic><topic>Viral Load - economics</topic><topic>Viral Load - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oyomopito, R</creatorcontrib><creatorcontrib>Lee, MP</creatorcontrib><creatorcontrib>Phanuphak, P</creatorcontrib><creatorcontrib>Lim, PL</creatorcontrib><creatorcontrib>Ditangco, R</creatorcontrib><creatorcontrib>Zhou, J</creatorcontrib><creatorcontrib>Sirisanthana, T</creatorcontrib><creatorcontrib>Chen, YMA</creatorcontrib><creatorcontrib>Pujari, S</creatorcontrib><creatorcontrib>Kumarasamy, N</creatorcontrib><creatorcontrib>Sungkanuparph, S</creatorcontrib><creatorcontrib>Lee, CKC</creatorcontrib><creatorcontrib>Kamarulzaman, A</creatorcontrib><creatorcontrib>Oka, S</creatorcontrib><creatorcontrib>Zhang, FJ</creatorcontrib><creatorcontrib>Mean, CV</creatorcontrib><creatorcontrib>Merati, T</creatorcontrib><creatorcontrib>Tau, G</creatorcontrib><creatorcontrib>Smith, J</creatorcontrib><creatorcontrib>Li, PCK</creatorcontrib><creatorcontrib>TREAT Asia HIV Observational Database</creatorcontrib><creatorcontrib>on behalf of The TREAT Asia HIV Observational Database</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>HIV medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oyomopito, R</au><au>Lee, MP</au><au>Phanuphak, P</au><au>Lim, PL</au><au>Ditangco, R</au><au>Zhou, J</au><au>Sirisanthana, T</au><au>Chen, YMA</au><au>Pujari, S</au><au>Kumarasamy, N</au><au>Sungkanuparph, S</au><au>Lee, CKC</au><au>Kamarulzaman, A</au><au>Oka, S</au><au>Zhang, FJ</au><au>Mean, CV</au><au>Merati, T</au><au>Tau, G</au><au>Smith, J</au><au>Li, PCK</au><aucorp>TREAT Asia HIV Observational Database</aucorp><aucorp>on behalf of The TREAT Asia HIV Observational Database</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD)</atitle><jtitle>HIV medicine</jtitle><addtitle>HIV Med</addtitle><date>2010-09</date><risdate>2010</risdate><volume>11</volume><issue>8</issue><spage>519</spage><epage>529</epage><pages>519-529</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract><![CDATA[Objectives
Surrogate markers of HIV disease progression are HIV RNA in plasma viral load (VL) and CD4 cell count (immune function). Despite improved international access to antiretrovirals, surrogate marker diagnostics are not routinely available in resource‐limited settings. Therefore, the objective was to assess effects of economic and diagnostic resourcing on patient treatment outcomes.
Methods
Analyses were based on 2333 patients initiating highly active antiretroviral therapy (HAART) from 2000 onwards. Sites were categorized by World Bank country income criteria (high/low) and annual frequency of VL (≥3, 1–2 or <1) or CD4 (≥3 or <3) testing. Endpoints were time to AIDS/death and change in CD4 cell count and VL suppression (<400 HIV‐1 RNA copies/mL) at 12 months. Demographics, Centers for Disease Control and Prevention (CDC) classification, baseline VL/CD4 cell counts, hepatitis B/C coinfections and HAART regimen were covariates. Time to AIDS/death was analysed by proportional hazards models. CD4 and VL endpoints were analysed using linear and logistic regression, respectively.
Results
Increased disease progression was associated with site‐reported VL testing less than once per year [hazard ratio (HR)=1.4; P=0.032], severely symptomatic HIV infection (HR=1.4; P=0.003) and hepatitis C virus coinfection (HR=1.8; P=0.011). A total of 1120 patients (48.2%) had change in CD4 cell count data. Smaller increases were associated with older age (P<0.001) and ‘Other’ HIV source exposures, including injecting drug use and blood products (P=0.043). A total of 785 patients (33.7%) contributed to the VL suppression analyses. Patients from sites with VL testing less than once per year [odds ratio (OR)=0.30; P<0.001] and reporting ‘Other’ HIV exposures experienced reduced suppression (OR=0.28; P<0.001).
Conclusion
Low measures of site resourcing were associated with less favourable patient outcomes, including a 35% increase in disease progression in patients from sites with VL testing less than once per year.]]></abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>20345881</pmid><doi>10.1111/j.1468-1293.2010.00822.x</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | HIV medicine, 2010-09, Vol.11 (8), p.519-529 |
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| source | MEDLINE; IngentaConnect Open Access Journals; Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Anti-Retroviral Agents - therapeutic use antiretroviral therapy Antiretroviral Therapy, Highly Active Antiviral agents Asia Asia - epidemiology CD4 antigen CD4 counts CD4 Lymphocyte Count - economics CD4 Lymphocyte Count - statistics & numerical data diagnostic monitoring Disease Progression Economics Female Health Services Accessibility - economics Healthcare Disparities - economics Hepatitis C - complications highly active antiretroviral therapy HIV Infections - complications HIV Infections - drug therapy HIV Infections - immunology HIV Infections - virology HIV-1 Human immunodeficiency virus Humans Immune response Income Male Models, Statistical Outcome and Process Assessment, Health Care Prospective Studies RNA RNA, Viral - blood Time Factors viral load Viral Load - economics Viral Load - statistics & numerical data |
| title | Measures of site resourcing predict virologic suppression, immunologic response and HIV disease progression following highly active antiretroviral therapy (HAART) in the TREAT Asia HIV Observational Database (TAHOD) |
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