Table 3.
Unadjusted and adjusted predictors of virologic suppression and virologic failure among patients initiated on a nevirapine- or efavirenz-based regimen between April 2004 and August 2011 in Johannesburg, South Africa
| Suppression within 12 months (n=9960) | Failure within 12 months (n=8854) | |||||
|---|---|---|---|---|---|---|
|
|
|
|||||
| Characteristic | Suppression/N (%) | Unadjusted RR (95% CI) | Adjusted RR (95% CI) | Failures/N(%) | Unadjusted RR (95% CI) | Adjusted RR (95% CI) |
| Regimen | ||||||
| Nevirapinea | 641/712 (90.0%) | 0.97 (0.95, 1.00) | 0.98 (0.95, 1.00) | 43/643 (6.7%) | 1.79 (1.31, 2.44) | 1.58 (1.13, 2.22) |
| Efavirenzb | 8571/9248 (92.7%) | Reference | Reference | 307/8211 (3.7%) | Reference | Reference |
| Year of ART initiation | ||||||
| 2004/2005 | 1981/2179 (90.9%) | Reference | Reference | 72/1944 (3.7%) | Reference | Reference |
| 2006/2007 | 2600/2718 (95.7%) | 1.05 (1.04, 1.07) | 1.05 (1.03, 1.06) | 93/2405 (3.9%) | 1.04 (0.77, 1.41) | 1.06 (0.78, 1.45) |
| 2008/2009 | 2756/2870 (96.0%) | 1.06 (1.04, 1.07) | 1.05 (1.03, 1.06) | 42/2404 (1.8%) | 0.47 (0.32, 0.69) | 0.51 (0.35, 0.76) |
| 2010/2011 | 1875/2193 (85.5%) | 0.94 (0.92, 0.96) | 0.94 (0.90, 0.98) | 143/2101 (6.8%) | 1.84 (1.39, 2.42) | 1.96 (1.17, 3.28) |
| Sex | ||||||
| Male | 3266/3601 (90.7%) | 0.97 (0.96, 0.98) | 1.03 (1.02, 1.05) | 139/3186 (4.4%) | 1.17 (0.95, 1.45) | 1.23 (0.98, 1.54) |
| Female | 5946/6359 (93.5%) | Reference | Reference | 211/5668 (3.7%) | Reference | Reference |
| Age at initiation | ||||||
| <30 | 1616/1769 (91.4%) | Reference | Reference | 80/1565 (5.1%) | Reference | Reference |
| 30–34 | 2098/2281 (92.0%) | 1.01 (0.99, 1.03) | 1.01 (0.99, 1.03) | 84/2045 (4.1%) | 0.80 (0.60, 1.08) | 0.84 (0.61, 1.14) |
| 35–39 | 2061/2224 (92.7%) | 1.01 (1.00, 1.03) | 1.02 (1.00, 1.04) | 74/1995 (3.7%) | 0.73 (0.53, 0.99) | 0.73 (0.53, 1.01) |
| 40–44 | 1460/1589 (91.9%) | 1.01 (0.99, 1.03) | 1.01 (0.99, 1.03) | 51/1390 (3.7%) | 0.72 (0.51, 1.01) | 0.69 (0.48, 0.99) |
| ≥45 | 1977/2097 (94.3%) | 1.03 (1.01, 1.05) | 1.03 (1.01, 1.05) | 61/1859 (3.3%) | 0.64 (0.46, 0.89) | 0.68 (0.48, 0.96) |
| Baseline CD4+ Count (cells/mm3) | ||||||
| <50 | 2545/2796 (91.0%) | 0.97 (0.95, 0.99) | 0.96 (0.95, 0.98) | 140/2480 (5.7%) | 2.57 (1.73, 3.81) | 2.74 (1.80, 4.17) |
| 50–99 | 1784/1953 (91.4%) | 0.97 (0.95, 0.99) | 0.97 (0.95, 0.99) | 72/1725 (4.2%) | 1.90 (1.24, 2.91) | 1.96 (1.25, 3.06) |
| 100–199 | 3486/3724 (93.6%) | 1.00 (0.98, 1.01) | 0.99 (0.97, 1.01) | 109/3328 (3.3%) | 1.49 (1.00, 2.24) | 1.52 (1.00, 2.31) |
| ≥200 | 1397/1487 (94.0%) | Reference | Reference | 29/1321 (2.2%) | Reference | Reference |
| WHO Stage | ||||||
| Stage I | 3726/4013 (92.9%) | Reference | Reference | 127/3577 (3.6%) | Reference | – |
| Stage II | 1584/1697 (93.3%) | 1.01 (0.99, 1.02) | 1.01 (0.99, 1.03) | 55/1503 (3.7%) | 1.03 (0.76, 1.41) | – |
| Stage III | 2702/2932 (92.2%) | 0.99 (0.98, 1.01) | 1.00 (0.98, 1.01) | 118/2607 (4.5%) | 1.27 (1.00, 1.63) | – |
| Stage IV | 1200/1318 (91.1%) | 0.98 (0.96, 1.00) | 1.00 (0.98, 1.02) | 50/1167 (4.3%) | 1.21 (0.88, 1.66) | – |
| Anaemia | ||||||
| No anaemia | 2452/2626 (93.4%) | Reference | Reference | 74/2336 (3.2%) | Reference | Reference |
| Mild anaemia | 2244/2421 (92.7%) | 0.99 (0.98, 1.01) | 1.00 (0.98, 1.01) | 81/2136 (3.8%) | 1.20 (0.88, 1.63) | 1.10 (0.81, 1.50) |
| Moderate anaemia | 3423/3717 (92.1%) | 0.99 (0.97, 1.00) | 0.99 (0.98, 1.01) | 148/3310 (4.5%) | 1.41 (1.07, 1.86) | 1.24 (0.93, 1.65) |
| Severe anaemia | 715/764 (93.6%) | 1.00 (0.98, 1.02) | 1.02 (1.00, 1.04) | 26/675 (3.9%) | 1.22 (0.78, 1.89) | 1.03 (0.66, 1.62) |
| BMI | ||||||
| <18.5 | 1348/1480 (91.1%) | 0.98 (0.97, 1.00) | 0.99 (0.97, 1.01) | 62/1287 (4.8%) | 1.28 (0.96, 1.69) | – |
| 18.5–24.9 | 4948/5349 (92.5%) | Reference | Reference | 180/4774 (3.8%) | Reference | – |
| 25–29.9 | 1574/1678 (93.8%) | 1.01 (1.00, 1.03) | 1.01 (1.00, 1.03) | 53/1515 (3.5%) | 0.93 (0.69, 1.25) | – |
| ≥30 | 730/763 (95.7%) | 1.03 (1.02, 1.05) | 1.02 (1.00, 1.04) | 22/661 (3.3%) | 0.88 (0.57, 1.36) | – |
| NRTI | ||||||
| Stavudine | 7276/7737 (94.0%) | Reference | Reference | 221/6746 (3.3%) | Reference | Reference |
| Zidovudine | 219/237 (92.4%) | 0.98 (0.95, 1.02) | 0.98 (0.94, 1.02) | 3/213 (1.4%) | 0.43 (0.14, 1.33) | 0.49 (0.16, 1.51) |
| Tenofovir | 1717/1986 (86.5%) | 0.92 (0.90, 0.94) | 1.00 (0.96, 1.04) | 126/1895 (6.7%) | 2.03 (1.64, 2.51) | 1.14 (0.70, 1.85) |
a
Nevirapine regimen includes tenofovir–lamivudine–nevirapine, zidovudine–lamivudine–nevirapine, stavudine–lamivudine–nevirapine;
b
efavirenz regimen includes tenofovir–lamivudine-efavirenz, zidovudine–lamivudine–efavirenz, stavudine–lamivudine–efavirenz.