Evaluation of the WHO criteria for antiretroviral treatment failure among adults in South Africa.
作者： Paul Mee , Katherine L Fielding , Salome Charalambous , Gavin J Churchyard , Alison D Grant
DOI: 10.1097/QAD.0B013E32830E4CD8
关键词: Tuberculosis 、 Sida 、 Viral disease 、 Viral load 、 Internal medicine 、 Immunology 、 Acquired immunodeficiency syndrome (AIDS) 、 Gold standard (test) 、 Cohort study 、 Population 、 Medicine
摘要: OBJECTIVE:: To assess the performance of WHO clinical and CD4 cell count criteria for antiretroviral treatment (ART) failure among HIV-infected adults in a workplace HIV care programme South Africa. DESIGN:: Cohort study. METHODS:: We included initially ART-naive participants who remained on first-line therapy had an evaluable viral load result at 12-month visit. WHO-defined ART were compared against gold standard virological failure. RESULTS:: Among 324 individuals (97.5% men, median age 40.2, starting 154 cells/mul 47 503 copies/ml, respectively), 33 (10.2%) definite or probable 12 months, with 19 (6.0%) 40 (12.5%) failure, respectively. sensitivity 21.2% specificity 95.8% detecting 15.2% 88.1%. The positive predictive value 36.8 12.8%, Exclusion weight loss tuberculosis failed to improve criteria. CONCLUSION:: have poor low specificities values mean that adequate suppression risk being incorrectly classified as having unnecessarily switched second-line therapy. Virological should be confirmed before switching
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