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A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland
Dissertation (MSc)--University of Pretoria, 2010.
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University of Pretoria
2013
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| _version_ | 1867613578483204096 |
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| access_status_str | Open Access |
| author2 | Louwagie, Goedele M.C. |
| author_browse | Louwagie, Goedele M.C. |
| author_facet | Louwagie, Goedele M.C. |
| collection | Thesis |
| dc_rights_str_mv | © 2011, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Dissertation (MSc)--University of Pretoria, 2010. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/30684 |
| institution | University of Pretoria (South Africa) |
| last_indexed | 2026-06-10T12:38:22.689Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2013 |
| publishDateRange | 2013 |
| publishDateSort | 2013 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/30684 A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland Louwagie, Goedele M.C. stakuva@wltshealth.co.za Zuma, Khangelani Takuva, Simbarashe G. UCTD Dissertation (MSc)--University of Pretoria, 2010. Background: Optimizing initial antiretroviral therapy (ART) regimens is of paramount importance in improving the durability of treatment efficacy and patient prognosis. We evaluated the reasons for and risk factors relating to ART modifications in an outpatient cohort in Mbabane, Swaziland. Methods: Retrospective cohort analysis of data for 782 patients who started first-line ART between 1 March 2006 and 31 March 2008. Multivariate piecewise Cox regression models were used to identify potential predictors of treatment modification. Results: Over a median follow-up period of 21 months, 17.5% of patients modified their regimen. Drug toxicity was the commonest reason (77 %) while drug contra-indications, namely tuberculosis (13.1%) and pregnancy (6.6%) accounted for 20% of the modifications. In the adjusted multivariate Cox piecewise regression model; after 11 months on ART, baseline CD4 cell count < 200cells/mm3 (HR = 4.42; 95% CI: 1.62 – 12.1), having Stavudine (d4T) in the initial regimen (HR = 2.64; 95% CI: 1.56 – 4.46) and baseline weight > 60kg (HR = 2.40; 95% CI: 1.43 – 4.04) significantly increased the hazards for modification. Conclusions: Initiating HAART at higher CD4 counts, avoiding drugs with poor safety profiles, such as Stavudine (d4T), and identifying individuals who may require therapy for tuberculosis or who may become pregnant could reduce modification rates. Clinical Epidemiology Unrestricted 2013-09-09T07:24:03Z 2011-05-19 2013-09-09T07:24:03Z 2011-04-15 2010 2011-03-14 Dissertation Takuva, S 2010, A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd < http://upetd.up.ac.za/thesis/available/etd-03142011-141031/ > C10/780/ag http://hdl.handle.net/2263/30684 http://upetd.up.ac.za/thesis/available/etd-03142011-141031/ © 2011, University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | UCTD A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland |
| title | A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland |
| title_full | A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland |
| title_fullStr | A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland |
| title_full_unstemmed | A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland |
| title_short | A retrospective cohort analysis of antiretroviral treatment modifications at the referral HIV clinic in Mbabane, Swaziland |
| title_sort | retrospective cohort analysis of antiretroviral treatment modifications at the referral hiv clinic in mbabane swaziland |
| topic | UCTD |
| url | http://hdl.handle.net/2263/30684 http://upetd.up.ac.za/thesis/available/etd-03142011-141031/ |