Table 3.
Unadjusted and adjusted estimates of virologic suppression at one-year and ever after second-line initiation among patients at four public-sector HIV treatment facilities in Johannesburg, South Africa.
|
|
|
|||||
|---|---|---|---|---|---|---|
| At one-year after second-line initiation (n=927)1 | Ever after second-line initiation (n=272)2 | |||||
|
|
|
|||||
| Characteristic | Suppressed/N (%) | Unadjusted RR (95% CI) | Adjusted RR (95% CI) | Suppressed/N (%) | Unadjusted RR (95% CI) | Adjusted RR (95% CI) |
|
|
|
|||||
| Year of second-line initiation | ||||||
|
|
|
|||||
| 2005/06 | 45/59 (76.3%) | Reference | Reference | 54/61 (88.5%) | Reference | Reference |
| 2007/08 | 160/205 (78.1%) | 1.02 (0.87 – 1.20) | 0.99 (0.85 – 1.15) | 178/211 (84.4%) | 0.95 (0.86 – 1.06) | 0.91 (0.83 – 1.01) |
| 2009/10 | 142/197 (72.1%) | 0.95 (0.80 – 1.12) | 0.88 (0.74 – 1.05) | – | – | – |
| 2011/12/13 | 347/466 (74.5%) | 0.98 (0.84 – 1.14) | 0.82 (0.65 – 1.03) | – | – | – |
|
|
|
|||||
| Sex | ||||||
|
|
|
|||||
| Male | 266/370 (71.9%) | Reference | Reference | 88/104 (84.6%) | Reference | Reference |
| Female | 428/557 (76.8%) | 1.07 (0.99 – 1.16) | 1.06 (0.97 – 1.15) | 144/168 (85.7%) | 1.01 (0.91 – 1.12) | 1.02 (0.91 – 1.14) |
|
|
|
|||||
| Age at initiation | ||||||
|
|
|
|||||
| <30 | 91/129 (70.5%) | Reference | Reference | 33/43 (76.7%) | Reference | Reference |
| 30–34 | 153/196 (78.1%) | 1.11 (0.97 – 1.27) | 1.12 (0.98 – 1.27) | 61/72 (84.7%) | 1.10 (0.91 – 1.34) | 1.13 (0.94 – 1.35) |
| 35–39 | 165/223 (74.0%) | 1.05 (0.92 – 1.20) | 1.09 (0.95 – 1.25) | 44/52 (84.6%) | 1.10 (0.90 – 1.35) | 1.09 (0.90 – 1.31) |
| 40–44 | 125/169 (74.0%) | 1.05 (0.91 – 1.21) | 1.08 (0.93 – 1.24) | 49/54 (90.7%) | 1.18 (0.98 – 1.42) | 1.19 (0.99 – 1.43) |
| ≥45 | 160/210 (76.2%) | 1.08 (0.94 – 1.24) | 1.12 (0.98 – 1.29) | 45/51 (88.2%) | 1.15 (0.95 – 1.39) | 1.20 (0.99 – 1.47) |
|
|
|
|||||
| Viral load (copies/ml) | ||||||
|
|
|
|||||
| <5000 | 207/264 (78.4%) | Reference | Reference | 67/74 (90.5%) | Reference | Reference |
| 5000 – 9999 | 99/126 (78.6%) | 1.00 (0.90 – 1.12) | 1.02 (0.91 – 1.14) | 39/43 (90.7%) | 1.00 (0.89 – 1.13) | 0.99 (0.88 – 1.12) |
| 10000 – 49999 | 222/286 (77.6%) | 0.99 (0.91 – 1.08) | 1.00 (0.91 – 1.10) | 78/91 (85.7%) | 0.95 (0.85 – 1.06) | 1.00 (0.90 – 1.12) |
| 50000 – 99999 | 66/92 (71.7%) | 0.91 (0.79 – 1.06) | 0.92 (0.79 – 1.06) | 18/22 (81.8%) | 0.90 (0.73 – 1.12) | 0.94 (0.76 – 1.16) |
| ≥100000 | 100/159 (62.9%) | 0.80 (0.70 – 0.92) | 0.79 (0.68 – 0.92) | 30/42 (71.4%) | 0.79 (0.64 – 0.97) | 0.85 (0.69 – 1.04) |
|
|
|
|||||
| CD4 count (cells/mm3) | ||||||
|
|
|
|||||
| <50 | 57/91 (62.6%) | 0.82 (0.69 – 0.97) | 0.86 (0.72 – 1.03) | 15/27 (55.6%) | 0.62 (0.44 – 0.87) | 0.65 (0.46 – 0.91) |
| 50–99 | 70/91 (76.9%) | 1.00 (0.89 – 1.14) | 1.05 (0.92 – 1.19) | 29/31 (93.6%) | 1.04 (0.93 – 1.15) | 1.08 (0.96 – 1.20) |
| 100–199 | 191/254 (75.2%) | 0.98 (0.90 – 1.07) | 1.00 (0.92 – 1.10) | 76/90 (84.4%) | 0.93 (0.84 – 1.04) | 0.96 (0.86 – 1.07) |
| ≥200 | 376/491 (76.6%) | Reference | Reference | 112/124 (90.3%) | Reference | Reference |
|
|
|
|||||
| Co-infected with tuberculosis | ||||||
|
|
|
|||||
| No | 672/899 (74.8%) | Reference | Reference | 229/268 (85.5%) | Reference | Reference |
| Yes | 22/28 (78.6%) | 1.05 (0.86 – 1.28) | 1.06 (0.86 – 1.29) | 3/4 (75.0%) | 0.88 (0.50 – 1.55) | 0.90 (0.55 – 1.48) |
|
|
|
|||||
| BMI | ||||||
|
|
|
|||||
| <18.5 | 30/44 (68.2%) | 0.93 (0.76 – 1.15) | 0.99 (0.80 – 1.22) | 12/15 (80.0%) | 0.99 (0.76 – 1.29) | 1.15 (0.87 – 1.48) |
| 18.5–24.9 | 327/448 (73.0%) | Reference | Reference | 105/130 (80.8%) | Reference | Reference |
| 25–29.9 | 204/265 (77.0%) | 1.05 (0.97 – 1.15) | 1.03 (0.94 – 1.12) | 72/78 (92.3%) | 1.14 (1.03 – 1.27) | 1.11 (1.00 – 1.23) |
| ≥30 | 133/170 (78.2%) | 1.07 (0.97 – 1.18) | 1.02 (0.92 – 1.13) | 43/49 (87.8%) | 1.09 (0.95 – 1.24) | 1.05 (0.92 – 1.21) |
|
|
|
|||||
| Anaemia3 | ||||||
|
|
|
|||||
| None | 408/540 (75.6%) | Reference | Reference | 149/167 (89.2%) | Reference | Reference |
| Mild | 167/227 (73.6%) | 0.97 (0.89 – 1.07) | 0.99 (0.91 – 1.09) | 49/61 (80.3%) | 0.90 (0.79 – 1.03) | 0.94 (0.83 – 1.07) |
| Moderate | 109/148 (73.7%) | 0.97 (0.88 – 1.09) | 0.99 (0.88 – 1.11) | 30/39 (76.9%) | 0.86 (0.72 – 1.03) | 0.89 (0.74 – 1.07) |
| Severe | 10/12 (83.3%) | 1.10 (0.85 – 1.43) | 1.12 (0.86 – 1.47) | 4/5 (80.0%) | 0.90 (0.58 – 1.39) | 1.08 (0.62 – 1.88) |
|
|
|
|||||
| First ART regimen | ||||||
|
|
|
|||||
| TDF-3TC-EFV | 117/145 (80.7%) | 1.12 (1.02 – 1.23) | 1.22 (1.07 – 1.39) | – | – | – |
| d4T-3TC-EFV | 461/639 (72.1%) | Reference | Reference | 200/235 (85.1%) | Reference | Reference |
| Other4 | 116/143 (81.1%) | 1.12 (1.03 – 1.23) | 1.15 (1.04 – 1.26) | 32/37 (86.5%) | 1.02 (0.89 – 1.17) | 1.03 (0.90 – 1.18) |
|
|
|
|||||
| Second-line ART regimen | ||||||
|
|
|
|||||
| TDF-3TC/EMT-LPVr5 | 204/284 (71.8%) | 0.95 (0.87 – 1.05) | 1.07 (0.91 – 1.26) | 3/3 (100%) | – | – |
| AZT-3TC-LPVr | 204/263 (77.6%) | 1.03 (0.94 – 1.12) | 1.13 (0.93 – 1.39) | 0/1 (0.0%) | – | – |
| AZT-ddI-LPVr | 286/380 (75.3%) | Reference | Reference | 229/268 (85.5%) | – | – |
|
|
|
|||||
1
One-year analyses include all patients with at least one viral load conducted between 3 and 12 months after second-line ART initiation and complete covariate information
2
Final analyses included only those patients who initiated second-line ART between 2005 and 2008, had at least one viral load conducted at least 3 months after second-line ART initiation and had complete covariate information
3
None: males: ≥13 g/dL, females: ≥12 g/dL; Mild: males: 11–12 g/dL, females: 11–11.9 g/dL; Moderate: 8–10 g/dL; Severe: <8 g/dL
4
Other regimens include: AZT-3TC-NVP/EFV, d4T-3TC-NVP, TDF-3TC-NVP, TDF-EMT-EFV
5
11 patients initiated TDF-EMT-LPVr