Naslov
Is less frequent monitoring of CD4 cell counts and viral load measurements more common in recent years and what are associated factors?

Autori
Begovac, Josip ; Lukas, Davorka ; Romih, Vanja ; Gedike, Kornelija ; Židovec-Lepej, Snježana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
AIDS 2010 - XVIII International AIDS Conference / - , 2010

Skup
AIDS 2010 - XVIII International AIDS Conference

Mjesto i datum
Beč, Austrija, 18.07.2010. - 23.07.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
Monitoring; CD4 cell; viral load measurements; recent years; associated factors

Sažetak
Background: We examined whether measurements of CD4 cell counts and viral load in patients who were initially well suppressed with combination antiretroviral therapy (CART) became less frequent in recent years. Examined were also HIV disease and sociodemographic factors related to the frequency of this monitoring. Methods: Included into the study were patients who started CART in the period 1999-2004, were older than 18 years, CART naive, had two consecutive viral load measurements of < 400 copies/ml after 5 months of treatment and had continuous CART during the first 15 months. The time between two visits (in months) was the outcome and associated factors were assessed using linear mixed models that accounts for repeated measurements. Results: A total of 128 patients had 1504 visits through December 2008. CART failure was observed in 30 (23%) patients. Follow-up time was modeled quadratic and at baseline, there was a mean initial estimated increase in the time between visits of +24 days in the first year. The time between visits adjusted for the duration of follow-up increased from an estimated mean of 4.3 months before 2003 to 5.7 months in 2008. On multivariable analysis, a longer time between visits was observed in seafarers (mean difference between seafarers and non-seafarers 0.9 (95% CI, 0.3 to 1.5) months (p=0.005) and individuals who lived more than 160 kilometers from the HIV center (mean difference, 0.4 months, p=0.03). At time of CART change, a shorter time between visits (mean difference, -0.5 months, p=0.001) was observed. CART failure, baseline CD4 cell count and risk group were not associated with a longer time between visits. Conclusions: Monitoring CD4 cell counts and viral load > 5 months apart became common in recent years. Working as a seafarer was the most important sociodemographic factor related to less frequent monitoring.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

POVEZANOST RADA