Marseille 2007
| Abstract #6 - Discontinuation and Modification of Highly Active Antiretroviral Therapy in HIV-Infected Ugandans: Prevalence and Associated Factors | ||||
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Session: 39.6: Treatment (Parallel) on Tuesday @ 14.00-16.00 in HC Chaired by Robin Hamilton, Raffaele Visintini Authors: Presenting Author: Mr Ronald Kiguba - Makerere University, Uganda |
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| Additional Authors: Ms Jayne Byakika-Tusiime, Dr Charles Karamagi, Dr Francis Ssali, Prof Peter Mugyenyi, Prof Elly Katabira, | ||||
| Aim: We sought to estimate the prevalence and to identify the factors associated with discontinuation and with modification of highly active antiretroviral therapy in our resource-limited setting. | ||||
| Method / Issue: Patients were recruited into this cross-sectional study from two treatment centers in Kampala, Uganda. Discontinuation and modification were assessed by self-report using semi-structured quantitative and unstructured qualitative interviews. Discontinuation was defined as the simultaneous stopping of all antiretrovirals for at least a month, and modification as the changing of at least one of the antiretrovirals used in an initial HAART regimen. Factors independently associated with each outcome were assessed using multivariate logistic regression. | ||||
| Results / Comments: Of 686 subjects evaluated, 94 (13.7%) had ever discontinued therapy while 175 (25.5%) had ever modified their regimen. The median CD4 cell count was 175 (IQR, 66-297) cells/L. Factors associated with discontinuation were; HAART experience prior to start of current regimen [odds ratio (OR), 3.70; 95 % confidence interval [CI], 2.13-6.25), use of alternative medicines (OR, 2.18; 95% CI, 1.06-4.47), hospitalization (OR, 2.36; 95% CI, 1.32-4.20) and duration on HAART (OR, 11.11; 95% CI, 5.00-25.00; less than 1 year versus more than 1 year). Modification was associated with; more than 3 months duration on HAART (OR, 3.13; 95% CI, 1.16-8.33) and marital status (OR, 1.64; 95% CI, 1.02-2.70; unmarried versus married). | ||||
| Discussion: The proportions of discontinuation and modification of antiretroviral therapy observed in our resource-poor setting pose a challenge to the limited treatment options presently available. The factors associated with discontinuation and with modification of HAART observed in this cross-sectional study should be investigated further in longitudinal studies of antiretroviral therapy utilization. | ||||
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