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dc.contributor.author | Salinas, Jorge L. | |
dc.contributor.author | Alave, Jorge L. | |
dc.contributor.author | Westfall, Andrew O. | |
dc.contributor.author | Paz, Jorge | |
dc.contributor.author | Moran, Fiorella | |
dc.contributor.author | Carbajal-Gonzalez, Danny | |
dc.contributor.author | Callacondo, David | |
dc.contributor.author | Avalos, Odalie | |
dc.contributor.author | Rodriguez, Martin | |
dc.contributor.author | Gotuzzo Herencia, José Eduardo | |
dc.contributor.author | Echevarria Zarate, Juan Ignacio | |
dc.contributor.author | Willig, JamesH. | |
dc.date.accessioned | 2022-01-04T20:31:49Z | |
dc.date.available | 2022-01-04T20:31:49Z | |
dc.date.issued | 2013 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12866/10692 | |
dc.description.abstract | Objectives: In developing nations, the use of operational parameters (OPs) in the prediction of clinical care represents a missed opportunity to enhance the care process. We modeled the impact of multiple measurements of antiretroviral treatment (ART) adherence on antiretroviral treatment outcomes in Peru. Design And Methods: Retrospective cohort study including ART naïve, non-pregnant, adults initiating therapy at Hospital Nacional Cayetano Heredia, Lima-Peru (2006-2010). Three OPs were defined: 1) Medication possession ratio (MPR): days with antiretrovirals dispensed/days on first-line therapy; 2) Laboratory monitory constancy (LMC): proportion of 6 months intervals with ≥1 viral load or CD4 reported; 3) Clinic visit constancy (CVC): proportion of 6 months intervals with ≥1 clinic visit. Three multi-variable Cox proportional hazard (PH) models (one per OP) were fit for (1) time of first-line ART persistence and (2) time to second-line virologic failure. All models were adjusted for socio-demographic, clinical and laboratory variables. Results: 856 patients were included in first-line persistence analyses, median age was 35.6 years [29.4-42.9] and most were male (624; 73%). In multivariable PH models, MPR (per 10% increase HR=0.66; 95%CI=0.61-0.71) and LMC (per 10% increase 0.83; 0.71-0.96) were associated with prolonged time on first-line therapies. Among 79 individuals included in time to second-line virologic failure analyses, MPR was the only OP independently associated with prolonged time to second-line virologic failure (per 10% increase 0.88; 0.77-0.99). Conclusions: The capture and utilization of program level parameters such as MPR can provide valuable insight into patient-level treatment outcomes. | en_US |
dc.language.iso | eng | |
dc.publisher | Public Library of Science | |
dc.relation.ispartofseries | PLoS ONE | |
dc.rights | info:eu-repo/semantics/restrictedAccess | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es | |
dc.subject | Humans | en_US |
dc.subject | major clinical study | en_US |
dc.subject | medication compliance | en_US |
dc.subject | patient compliance | en_US |
dc.subject | Peru | en_US |
dc.subject | Risk Factors | en_US |
dc.subject | HIV Infections | en_US |
dc.subject | Human immunodeficiency virus infection | en_US |
dc.subject | antiretrovirus agent | en_US |
dc.subject | cohort analysis | en_US |
dc.subject | CD4 lymphocyte count | en_US |
dc.subject | Retrospective Studies | en_US |
dc.subject | retrospective study | en_US |
dc.subject | article | en_US |
dc.subject | HIV-1 | en_US |
dc.subject | Antiretroviral Therapy, Highly Active | en_US |
dc.subject | drug treatment failure | en_US |
dc.subject | drug withdrawal | en_US |
dc.subject | Treatment Failure | en_US |
dc.subject | Delivery of Health Care | en_US |
dc.subject | Outcome Assessment (Health Care) | en_US |
dc.subject | clinic visit constancy | en_US |
dc.subject | drug substitution | en_US |
dc.subject | health care concepts | en_US |
dc.subject | Human immunodeficiency virus proteinase inhibitor | en_US |
dc.subject | laboratory monitoring constancy | en_US |
dc.subject | medication possession ratio | en_US |
dc.subject | nonnucleoside reverse transcriptase inhibitor | en_US |
dc.subject | RNA directed DNA polymerase inhibitor | en_US |
dc.subject | virus load | en_US |
dc.title | Medication Possession Ratio Predicts Antiretroviral Regimens Persistence in Peru | en_US |
dc.type | info:eu-repo/semantics/article | |
dc.identifier.doi | https://doi.org/10.1371/journal.pone.0076323 | |
dc.subject.ocde | https://purl.org/pe-repo/ocde/ford#3.01.05 | |
dc.relation.issn | 1932-6203 |
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