Survival Analysis of Time to Treatment Resumption for Chronic Hiv-1 Patients Interrupting Highly Active Antiretroviral Therapy (Heart)
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Date
2009-06
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Addis Abeba university
Abstract
Highly active antiretroviral therapy (HAART) has significantly reduced mortality caused by
human immuno-deficiency virus (HIV) by enhancing the physiological and immunological
ability to counterattack against the virus and increases the life expectancy. Once started, the
antiretroviral treatment should be continued lifelong and adherence to this treatment should be
nearly perfect to enable long-term efficacy. A continuous and life-long treatment with
HAART may lead to a broad spectrum of significant toxicities. As a result many patients
interrupt their HAART without the knowledge and advice of the clinicians and this cause the
patient immune to degrade and even cause to death. Therefore, this study is an attempt to
examine the predictive factors of interruption duration in patients who interrupt their ARV
drugs treatment.
The study is a retrospective cohort study of HIV/AIDS patients under HAART but
discontinued their treatment for at least one month, which comprises a total of 723 patients
from Zewditu Memorial Hospital. Of these patients about 67% resumed their treatment. In the
analysis of data the Kaplan-Meier survival estimator and Cox proportional hazards regression
model are used. Based on the data analysis, it is found that main effects: education, baseline
age, baseline weight, CD4 count at the start of HAART and prior to interruption, duration on
HAART and interaction effects: marital status with disease duration and marital status with
sex are important factors that are related to time to resumption of HAART.
In general, HIV/AIDS patients who have prolonged treatment interruption are characterized
by having lower level of education, younger age, high weight, higher CD4 count at the start of
HAART, lower CD4 count prior to treatment interruption, longer duration on treatment
follow-up and currently not married and male patients with longer disease duration
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Keywords
Resumption for Chronic Hiv-1 Patients