Short-term rationing of combination antiretroviral therapy

Impact on morbidity, mortality, and loss to follow-up in a large HIV treatment program in Western Kenya

April J. Bell, Kara Wools-Kaloustian, Sylvester Kimaiyo, Hai Liu, Adrian Katschke, Changyu Shen, Gilbert Simiyu, Beverly S. Musick, John Sidle, Abraham Siika, Paula Braitstein

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background. There was a 6-month shortage of antiretrovirals (cART) in Kenya. Methods. We assessed morbidity, mortality, and loss to follow-up (LTFU) in this retrospective analysis of adults who were enrolled during the six-month period with restricted cART (cap) or the six months prior (pre-cap) and eligible for cART at enrollment by the pre-cap standard. Cox models were used to adjust for potential confounders. Results. 9009 adults were eligible for analysis: 4,714 pre-cap and 4,295 during the cap. Median number of days from enrollment to cART initiation was 42 pre-cap and 56 for the cap (P < 0.001). After adjustment, individuals in the cap were at higher risk of mortality (HR = 1.21; 95% CI: 1.06-1.39) and LTFU (HR = 1.12; 95% CI: 1.04-1.22). There was no difference between the groups in their risk of developing a new AIDS-defining illness (HR = 0.92 95% CI 0.82-1.03). Conclusions. Rationing of cART, even for a relatively short period of six months, led to clinically adverse outcomes.

Original languageEnglish
Article number814564
JournalAIDS Research and Treatment
Volume2012
DOIs
StatePublished - 2012

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Kenya
HIV
Morbidity
Mortality
Proportional Hazards Models
Acquired Immunodeficiency Syndrome
Therapeutics

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology and Allergy
  • Infectious Diseases
  • Dermatology

Cite this

Short-term rationing of combination antiretroviral therapy : Impact on morbidity, mortality, and loss to follow-up in a large HIV treatment program in Western Kenya. / Bell, April J.; Wools-Kaloustian, Kara; Kimaiyo, Sylvester; Liu, Hai; Katschke, Adrian; Shen, Changyu; Simiyu, Gilbert; Musick, Beverly S.; Sidle, John; Siika, Abraham; Braitstein, Paula.

In: AIDS Research and Treatment, Vol. 2012, 814564, 2012.

Research output: Contribution to journalArticle

Bell, April J. ; Wools-Kaloustian, Kara ; Kimaiyo, Sylvester ; Liu, Hai ; Katschke, Adrian ; Shen, Changyu ; Simiyu, Gilbert ; Musick, Beverly S. ; Sidle, John ; Siika, Abraham ; Braitstein, Paula. / Short-term rationing of combination antiretroviral therapy : Impact on morbidity, mortality, and loss to follow-up in a large HIV treatment program in Western Kenya. In: AIDS Research and Treatment. 2012 ; Vol. 2012.
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