Accuracy of WHO immunological criteria in identifying virological failure among HIV-infected adults on First line antiretroviral therapy in Mwanza, North-western Tanzania (Record no. 19374)

MARC details
000 -LEADER
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003 - CONTROL NUMBER IDENTIFIER
control field OSt
005 - DATE AND TIME OF LATEST TRANSACTION
control field 20240305193725.0
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022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1756-0500
028 ## - PUBLISHER OR DISTRIBUTOR NUMBER
Source Phone: +255 28 298 3384
Source Fax: +255 28 298 3386
Source Email: vc@bugando.ac.tz
Source Website: www.bugando.ac.tz
040 ## - CATALOGING SOURCE
Transcribing agency DLC
041 ## - LANGUAGE CODE
Language code of text/sound track or separate title English
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Daniel W Gunda
9 (RLIN) 22748
222 ## - KEY TITLE
Key title HIV/AIDS Antiretroviral therapy Treatment failure Immunological monitoring
245 ## - TITLE STATEMENT
Title Accuracy of WHO immunological criteria in identifying virological failure among HIV-infected adults on First line antiretroviral therapy in Mwanza, North-western Tanzania
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Place of publication, distribution, etc. Mwanza:
Name of publisher, distributor, etc. BioMed Central &
-- Tanzania Catholic University of Health and Allied Sciences [CUHAS – Bugando]
Date of publication, distribution, etc. 17 January 2017
300 ## - PHYSICAL DESCRIPTION
Extent Pages 1-5
490 ## - SERIES STATEMENT
Volume/sequential designation BMC research notes Volume 10 Issue 1
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Summary, etc. Abstract<br/><br/>Background: Optimal HIV treatment monitoring remains a big challenge in resource limited settings. Guidelines recommend the use of clinical and immunological criteria in resource limited settings due to unavailability of viral load monitoring; however their utility is questionable. This study aimed at assessing the accuracy of immunological criteria in detecting treatment failure among HIV infected Tanzanian adults receiving first line ART.<br/><br/>Methods: A clinic based cross sectional study was conducted between February and July 2011 at Bugando Medical centre (BMC) HIV care and treatment clinic (CTC) involving HIV infected patients aged 18 years and above, receiving first line ART; followed up for at least 1 year. Viral load was tested for every enrolled patient. Standard WHO criteria were used to define immunological failure. Virological failure was defined as one viral load measurement of >5000 copies/ml and was used as a gold standard. A 2 × 2 table was used to assess the accuracy of immunological criteria in detecting treatment failure.<br/><br/>Results: A total of 274 HIV-infected adults were enrolled into the study. Out of these, 65.7% were females, the median age was 39 years (IQR 33–45), the median BMI 21.9 kg/m2 (IQR 19.7–24.0). Out of the 274 study participants 156 (56.9%) had immunological failure. Only 60 of the study participants (21.9%) had viral load >5000. Only 42 patients (70%) were found to have both immunological failure and virological failure. The sensitivity of immunological criteria in detecting treatment failure was 70%, specificity 46.7%, positive predictive and negative predictive values of 26.9 and 84.7% respectively.<br/><br/>Conclusion: WHO immunological criteria have low sensitivity and positive predictive value for detecting treatment failure. Relying on CD4 counts for treatment monitoring would therefore lead to misclassifications of treatment failure that could result into unnecessary or delayed switch to second line ART. Access to viral load monitoring is important to avoid these misclassifications.
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9 (RLIN) 22909
9 (RLIN) 15820
9 (RLIN) 22704
9 (RLIN) 45244
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="https://doi.org/10.1186/s13104-016-2334-6">https://doi.org/10.1186/s13104-016-2334-6</a>
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Source of classification or shelving scheme ddc
Koha item type RESEARCH ARTICLES
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