Marita Mann1, Lameck Diero2,3, Emmanuel Kemboi2,3, Fidelis Mambo2,3, Mary Rono2,3, Wilfred Injera2,3, Allison Delong4, Leeann Schreier5, Kara W Kaloustian6, John Sidle7, Nathan Buziba2,3, Rami Kantor5. 1. Department of Public Health, Brown University, Providence, RI. 2. Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. 3. Academic Model Providing Access To Health Care (AMPATH), Eldoret, Kenya. 4. Center for Statistical Sciences, Brown University, Providence, RI. 5. Department of Medicine, Division of Infectious Diseases, Warren Alpert Medical School, Brown University, Providence, RI. 6. Department of Medicine, Division of Infectious Diseases, Indiana University, Indianapolis, IN. 7. Department of Medicine, Division of General Internal Medicine, Indiana University, Indianapolis, IN.
Abstract
BACKGROUND: Antiretroviral treatment interruptions (TIs) cause suboptimal clinical outcomes. Data on TIs during social disruption are limited. METHODS: We determined effects of unplanned TIs after the 2007-2008 Kenyan postelection violence on virological failure, comparing viral load (VL) outcomes in HIV-infected adults with and without conflict-induced TI. RESULTS: Two hundred and one patients were enrolled, median 2.2 years after conflict and 4.3 years on treatment. Eighty-eight patients experienced conflict-related TIs and 113 received continuous treatment. After adjusting for preconflict CD4, patients with TIs were more likely to have detectable VL, VL >5,000 and VL >10,000. CONCLUSIONS: Unplanned conflict-related TIs are associated with increased likelihood of virological failure.
BACKGROUND: Antiretroviral treatment interruptions (TIs) cause suboptimal clinical outcomes. Data on TIs during social disruption are limited. METHODS: We determined effects of unplanned TIs after the 2007-2008 Kenyan postelection violence on virological failure, comparing viral load (VL) outcomes in HIV-infected adults with and without conflict-induced TI. RESULTS: Two hundred and one patients were enrolled, median 2.2 years after conflict and 4.3 years on treatment. Eighty-eight patients experienced conflict-related TIs and 113 received continuous treatment. After adjusting for preconflict CD4, patients with TIs were more likely to have detectable VL, VL >5,000 and VL >10,000. CONCLUSIONS: Unplanned conflict-related TIs are associated with increased likelihood of virological failure.
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