Document Detail

Adult clinical and immunologic outcomes of the national antiretroviral treatment program in Rwanda during 2004-2005.
MedLine Citation:
PMID:  19617847     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: By December 2007, over 48,000 persons had initiated antiretroviral treatment (ART) at 171 clinics in Rwanda. Assessing national ART program outcomes is essential to determine whether programs have the desired impact. METHODS: We conducted a retrospective cohort study to assess key 6- and 12-month outcomes among a nationally representative, stratified, random sample of 3194 adults (> or =15 years) who initiated ART from January 1, 2004, through December 31, 2005. FINDINGS: At ART initiation, the median patient age was 37 years and 65% were female. Overall, the baseline median CD4 cell count was 141 cells per microliter. At 6 and 12 months after ART initiation, 92% and 86% of patients, respectively, remained on ART at their original site. By 6 months, 3.6% were dead and 3.4% were lost to follow-up; by 12 months, 4.6% were dead and 4.9% were lost to follow-up. Among patients with available follow-up CD4 cell count data, median CD4 cell counts increased by 98 cells per microliter and 119 cells per microliter at 6 and 12 months after ART initiation, respectively. CONCLUSIONS: Rwanda's national ART program achieved excellent 6- and 12-month retention and immunologic outcomes during the first 2 years of rapid scale-up. Routine supervision is required to improve compliance with clinical guidelines and data quality.
David W Lowrance; Francois Ndamage; Eugenie Kayirangwa; Felix Ndagije; Wilson Lo; Donald R Hoover; Jeff Hanson; Batya Elul; Aliou Ayaba; Tedd Ellerbrock; Alphonse Rukundo; Fabienne Shumbusho; Denis Nash; Jules Mugabo; Anita Assimwe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  52     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-25     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-55     Citation Subset:  IM; X    
Global AIDS Program, US Centers for Disease Control and Prevention, Kigali, Rwanda.
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MeSH Terms
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Cohort Studies
Developing Countries
HIV Infections / drug therapy*,  immunology*,  virology
Middle Aged
Multivariate Analysis
Program Evaluation / statistics & numerical data*
Protease Inhibitors / therapeutic use
Retrospective Studies
Reverse Transcriptase Inhibitors / therapeutic use
Survival Analysis
Treatment Outcome
Reg. No./Substance:
0/Protease Inhibitors; 0/Reverse Transcriptase Inhibitors

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