dc.contributor |
Universitat de Vic - Universitat Central de Catalunya. Càtedra de la Sida i Malalties Relacionades |
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dc.contributor.author |
Rupérez, María
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dc.contributor.author |
Pou, Christian
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dc.contributor.author |
Maculuve, Sonia
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dc.contributor.author |
Cedeño, Samandhy
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dc.contributor.author |
Luis, Leopoldina
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dc.contributor.author |
Rodríguez, Judith
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dc.contributor.author |
Letang, Emilio
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dc.contributor.author |
Moltó, José
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dc.contributor.author |
Macete, Eusébio
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dc.contributor.author |
Clotet, Bonaventura
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dc.contributor.author |
Alonso, Pedro
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dc.contributor.author |
Menéndez, Clara
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dc.contributor.author |
Naniche, Denise
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dc.contributor.author |
Paredes, Roger
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dc.date.accessioned |
2015-11-18T12:26:10Z |
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dc.date.available |
2015-11-18T12:26:10Z |
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dc.date.created |
2015 |
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dc.date.issued |
2015 |
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dc.identifier.citation |
Ruperez, M., Pou, C., Maculuve, S., Cedeno, S., Luis, L., Rodriguez, J., et al. (2015). Determinants of virological failure and antiretroviral drug resistance in mozambique. Journal of Antimicrobial Chemotherapy, 70(9), 2639-2647. |
ca_ES |
dc.identifier.issn |
1460-2091 |
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dc.identifier.uri |
http://hdl.handle.net/10854/4362 |
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dc.description.abstract |
Objectives: The objective of this study was to inform public health actions to limit first-line ART failure and HIV
drug resistance in Mozambique.
Methods: This was a cross-sectional study. HIV-1-infected adults on first-line ART for at least 1 year attending
routine visits in the Manhic¸a District Hospital, in a semi-rural area in southern Mozambique with no HIV-1 RNA
monitoring available, were evaluated for clinical, socio-demographic, therapeutic, immunological and virological
characteristics. Factors associated with HIV-1 RNA ≥1000 copies/mL and HIV drug resistance were determined
using multivariate logistic regression.
Results: The study included 334 adults on first-line ART for a median of 3 years, of which 65% (214/332)
had suppressed viraemia, 11% (37/332) had low-level viraemia (HIV-1 RNA 150–999 copies/mL) and 24%
(81/332) had overt virological failure (HIV-1 RNA ≥1000 copies/mL). HIV drug resistance was detected in 89%
of subjects with virological failure, but in none with low-level viraemia. Younger age [OR¼0.97 per additional
year (95% CI¼0.94–1.00), P¼0.039], ART initiation at WHO stage III/IV [OR¼2.10 (95% CI¼1.23–3.57),
P¼0.003] and low ART adherence [OR¼2.69 (95% CI¼1.39–5.19), P¼0.003] were associated with virological
failure. Longer time on ART [OR¼1.55 per additional year (95% CI¼1.00–2.43), P¼0.052] and illiteracy
[OR¼0.24 (95% CI¼0.07–0.89), P¼0.033] were associated with HIV drug resistance. Compared with HIV-1
RNA, clinician’s judgement of ART failure, based on clinical and immunological outcomes, only achieved 29%
sensitivity and misdiagnosed 1 out of every 4.5 subjects.
Conclusions: Public health programmes in Mozambique should focus on early HIV diagnosis, early ART initiation
and adherence support. Virological monitoring drastically improves the diagnosis of ART failure, enabling a better
use of resources. |
ca_ES |
dc.format |
application/pdf |
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dc.format.extent |
9 p. |
ca_ES |
dc.language.iso |
eng |
ca_ES |
dc.publisher |
Oxford University Press |
ca_ES |
dc.rights |
Tots els drets reservats |
ca_ES |
dc.rights |
(c) Oxford University Press |
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dc.subject.other |
Sida -- Tractament |
ca_ES |
dc.subject.other |
VIH (Virus) |
ca_ES |
dc.title |
Determinants of virological failure and antiretroviral drug resistance in Mozambique |
ca_ES |
dc.type |
info:eu-repo/semantics/article |
ca_ES |
dc.identifier.doi |
https://doi.org/10.1093/jac/dkv143 |
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dc.rights.accessRights |
info:eu-repo/semantics/closedAccess |
ca_ES |
dc.type.version |
info:eu-repo/publishedVersion |
ca_ES |
dc.indexacio |
Indexat a WOS/JCR |
ca_ES |
dc.indexacio |
Indexat a SCOPUS |
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