Practices to improve identification of adult antiretroviral therapy failure at the Lighthouse Trust clinic in Lilongwe, Malawi

Tropical Medicine and International Health

Volumn 17, Issue 2, 2012, Pages 169-176

  Vorkas, Charles K ^a   Tweya, Hannock ^b   Mzinganjira, Dalitso ^a   Dickie, George ^a   Weigel, Ralf ^b   Phiri, Sam ^b   Hosseinipour, Mina C ^a  

^a UNIVERSITY OF NORTH CAROLINA PROJECT   (Malawi)

^b LIGHTHOUSE TRUST   (Malawi)

Author keywords

Antiretroviral therapy; Capacity building; Immunologic and virologic screening; Second line therapy; Treatment failure

Indexed keywords

EFAVIRENZ; LAMIVUDINE; NEVIRAPINE; STAVUDINE; ZIDOVUDINE;

ADULT; BASELINE CONDITIONS; GUIDELINE; HEALTH RISK; IMMUNOASSAY; PUBLIC HEALTH; VIRAL DISEASE; WORLD HEALTH ORGANIZATION;

ADULT; ARTICLE; CD4 LYMPHOCYTE COUNT; DRUG MONITORING; DRUG TREATMENT FAILURE; EVALUATION; FEMALE; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; MAJOR CLINICAL STUDY; MALAWI; MALE; OUTCOME ASSESSMENT; PRACTICE GUIDELINE; SCREENING TEST; TREATMENT OUTCOME; VIROLOGICAL ASSESSMENT FORM; VIRUS LOAD;

ADOLESCENT; AMBULATORY CARE FACILITIES; ANTI-HIV AGENTS; CD4 LYMPHOCYTE COUNT; ELECTRONIC HEALTH RECORDS; FEMALE; GUIDELINES AS TOPIC; HIV INFECTIONS; HUMANS; MALAWI; MALE; RETROSPECTIVE STUDIES; TREATMENT FAILURE; VIRAL LOAD; WORLD HEALTH ORGANIZATION; YOUNG ADULT;

LILONGWE; MALAWI;

EID: 84855971172     PISSN: 13602276     EISSN: 13653156     Source Type: Journal    
DOI: 10.1111/j.1365-3156.2011.02912.x     Document Type: Article

References (34)

1. Assefa Y, Damme WV & Hermann K (2010) Human resource aspects of antiretroviral treatment delivery models: current practices and recommendations. Current Opinion in HIV and AIDS 5, 78-82.
2. Bendavid E, Young SD, Katzenstein DA et al. (2008) Cost-effectiveness of HIV monitoring strategies in resource-limited settings: a Southern African analysis. Archives of Internal Medicine 168, 1910-1918.
3. Bositis C, Haloka J & Kaonga A et al. (2009). Failure to Switch or Delay in Switching Patients who meet WHO Immunologic Criteria for 1st Regimen Failure at Two Urban Clinics in Lusaka, Zambia [MOPED051]. Presented at: 5th IAS Conference on HIV pathogenesis, Capetown.
4. Castelnuovo B, Kiragga A, Schaefer P et al. (2009) High rate of misclassification of treatment failure based on WHO immunological criteria. AIDS 23, 1295-1296.
5. Coutinho A, Mermin J & Ekwaru J et al. (2008). Utility of Routine Viral Load, CD4 Cell Count, and Clinical Monitoring among HIV-infected Adults in Uganda: A Randomized Trial [Paper #125]. Presented at: 15th Conference on Retroviruses and Opportunistic Infections, Boston.
6. DART Trial Team (2010) Routine versus clinically driven laboratory monitoring of HIV antiretroviral therapy in Africa (DART): a randomized non-inferiority trial. Lancet 375, 123-131.
7. Department of Health and Human Services (2011). Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Available at: (accessed 20 January 2011).
8. Douglas GP, Gadabu O, Joukes S et al. (2010) Using Touchscreen Electronic Medical Record Systems to Support and Monitor Scale-Up of Antiretroviral Therapy in Malawi. PLoS Medicine 7, 1-6.
9. Geng EH, Wools-Kaloustian K & Silika A et al. (2009). The Positive Predictive Value of World Health Organization (WHO) Immunologic Criteria for Treatment Failure in a Public Health Antiretroviral Delivery Network in Africa [CDD027]. Presented at: 5th IAS Conference on HIV pathogenesis, Capetown.
10. 3 Can Markedly Reduce Switching to Second-line ART in African Patients Managed without CD4 or Viral Monitoring [Paper #676]. Presented at: 18th Conference on Retroviruses and Opportunistic Infections, Boston.
11. Hammer SM, Eron JJ, Reiss P et al. (2008) Recommendations of the International AIDS Antiretroviral Treatment of Adult HIV Infection: 2008. JAMA 300, 555-570.
12. HIV Unit: Ministry of Health of Malawi (2009). Malawi ART Programme Report for Quarter 4 2009. Available at:.
13. Hosseinipour MC & Schechter M (2010) Monitoring antiretroviral therapy in resource-limited settings: balancing clinical care, technology, and human resources. Current HIV/AIDS Reports 7, 168-174.
14. Hosseinipour MC, Van Oosterhout JJG, Weigel R et al. (2009) The public health approach to identify antiretroviral therapy failure: high-level nucleoside reverse transcriptase inhibitor resistance among Malawians failing first-line antiretroviral therapy. AIDS 23, 1127-1134.
15. Joint United Nations Programme on HIV/AIDS (2009). 2009 AIDS Epidemic Update. Available at:.
16. Jourdain G, Ngo-Giang-Huong N & Le Coeur S et al. (2011). PHPT-3: A Randomized Clinical Trial Comparing CD4 vs Viral Load ART Monitoring/Switching Strategies in Thailand [Paper #44]. Presented at: 18th Conference on Retroviruses and Opportunistic Infections, Boston.
17. Kantor R, Shafer RW, Follansbee S et al. (2004) Evolution of resistance to drugs in HIV-1-infected patients failing antiretroviral therapy. AIDS 18, 1503-1511.
18. Keiser O, Tweya H, Braitstein P et al. (2010) Mortality after failure of antiretroviral therapy in sub-Saharan Africa. Tropical Medicine and International Health 15, 251-258.
19. Kouanfack C, Laurent C & Laborde-Balen G et al. (2011). HIV Viral Load, CD4 Cell Count, and Clinical Monitoring versus Clinical Monitoring Alone for ART in Rural Hospitals in Cameroon: Stratall ANRS 12110/ESTHER Trial, a Randomized Non-inferiority Trial [45 LB]. Presented at: Presented at: 18th Conference on Retroviruses and Opportunistic Infections, Boston.
20. Lester RT, Ritvo P, Mills EJ et al. (2010) Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 376, 1838-1845.
21. Lofgren SM, Morrissey AB, Chevallier CC et al. (2009) Evaluation of dried blood spot HIV-1 RNA Program for early infant diagnosis and viral load monitoring at rural and remote healthcare facilities. AIDS 23, 2459-2466.
22. Makombe SD, Hochgesang M, Jahn A et al. (2008) Assessing the quality of data aggregated by antiretroviral treatment clinics in Malawi. Bulletin of the World Health Organization 86, 310-314.
23. McGuire M, Kanaphathipillai R & Mogha R et al. (2009). What is the benefit of confirming diagnosed immunological failure with virological testing in ART patients treated in rural Malawi? [MOPDD105] Presented at: 5th IAS Conference on HIV pathogenesis, Capetown.
24. Mee P, Fielding K, Charalambous S et al. (2008) Evaluation of the WHO criteria for antiretroviral treatment failure among adults in South Africa. AIDS 22, 1971-1977.
25. Meya D, Spacek LA, Tibenderana H et al. (2009) Development and evaluation of a clinical algorithm to monitor patients on antiretrovirals in resource-limited settings using adherence, clinical and CD4 criteria. Journal of Acquired Immune Deficiency Syndromes 12, 3-12.
26. Moore DM, Awor A, Downing R et al. (2008) CD4+ T-cell count monitoring does not accurately identify HIV-infected adults with virologic failure receiving antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes 49, 477-484.
27. Philips AN, Pillay D, Miners AH et al. (2008) Outcomes from monitoring of patients on antiretroviral therapy in resource-limited settings with viral load, CD4 cell count, or clinical observation alone: a computer simulation model. Lancet 371, 1443-1451.
28. Reynolds SJ, Nakigozi G, Newell K et al. (2009) Failure of immunologic criteria to appropriately identify antiretroviral treatment failure in Uganda. AIDS 23, 697-700.
29. Sanne I, Orrell C, Fox MP et al. (2010) Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA: a randomized non-inferiority trial). Lancet 376, 33-40.
30. van Oosterhout JJ, Brown L, Weigel R et al. (2009) Diagnosis of antiretroviral therapy failure in Malawi: poor performance of clinical and immunological WHO criteria. Tropical Medicine and International Health 14, 856-861.
31. Weigel R, Phiri S, Chiputula F et al. (2010) Growth response to antiretroviral treatment in HIV-infected children: a cohort study from Lilongwe, Malawi. Tropical Medicine and International Health 15, 934-944.
32. Were MC, Emenyonu N, Achieng M et al. (2010) Evaluating a scalable model for implementing electronic health records in resource-limited settings. Journal of the American Medical Informatics Association 17, 237-244.
33. WHO (2009). Rapid Advice: antiretroviral therapy in adults and adolescents. November 2009. Available at:.
34. WHO, UNICEF and UNAIDS (2010). Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector: Progress Report 2010. Available at:.