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Background and Results

Are Patients on HAART in Uganda experiencing less treatment failure than earlier anticipated? A case study of Mbarara JCRC HAART Clinic. Francis Kiweewa , Harriet Namata , Abbas Lugemwa , Nicholas Musinguzi , Winnie Muyindike , Ann Nakirijja , Cissy Kityo , Peter Mugyenyi.

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Background and Results

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  1. Are Patients on HAART in Uganda experiencing less treatment failure than earlier anticipated? A case study of Mbarara JCRC HAART Clinic Francis Kiweewa, Harriet Namata, AbbasLugemwa, Nicholas Musinguzi, Winnie Muyindike, Ann Nakirijja, CissyKityo, Peter Mugyenyi

  2. Background and Results • Data from observational studies and programs indicate excellent response to ART in Africa • Prolonged treatment associated 20-30% failure rate • Prevalence of HIVDR mutations in the range 0f 5-10% • Infrequent laboratory monitoring and screening for treatment failure Goal: To determine the prevalence and determinants of HIV treatment failure Outcome: CD4 < 200cell/ul & VL > 400c/ml OR a VL > 5000c/ml (>12 mos on HAART) OR already switched to 2nd line Results • 4719 evaluable patients • 60% Female, and 53% married • 46% initiated ART at WHO stage 3/4 • 2.1% (100/4,719) met definition of treatment failure • 51% of failing patients were still using the same failing regimen

  3. Distribution and determinants of treatment Failure Figure 2: Definition and distribution of Treatment failure Table 1: Predictors of HIV treatment Failure

  4. Conclusions • Treatment failure may not be as common as would be expected from the high prevalence of HIVDR mutations • However identification and management of treatment failure is delayed compromising the quality of care for experienced patients • Given good adherence, duration on therapy seems to be the most important determinant of treatment failure

  5. Acknoledgement • Mbarara RCE HAART clinic staff • JCRC management • Mr. Joshua Kayiwa- biostatistician JCRC • The TREAT program and USAID Kampala

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