title: Direct observation therapy-highly active antiretroviral therapy in a resource-limited setting: the use of community treatment support can be effective.
abstract: This study examines the use of various direct observation therapy-HAART treatment support modalities in Jos, Nigeria. A 12-month observational study enrolling 175 antiretroviral naïve patients into four arms of direct observation therapy-HAART (highly active antiretroviral therapy); daily observed therapy (DOT), twice weekly observed therapy (TWOT), weekly observed therapy (WOT) and self-administered therapy (SAT), examined community treatment support using family and community members. Treatment outcomes were much better in the treatment-supported groups compared with the control self-therapy group. CD4 cell increases were 218/microL (DOT), 267/microL (TWOT), 205/microL (WOT) versus 224/microL (SAT), whereas plasma HIV-1 RNA reached undetectable levels (<400 copies/mL) in 91%, 88%, 84% versus 79% of patients in the DOT, TWOT, WOT versus SAT groups, respectively, at 48 weeks. We, therefore, strongly support the use of treatment support in our settings.
authors.affiliation: AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria. jonidoko@yahoo.com
authors.forename: J A
authors.initials: JA
authors.lastname: Idoko
authors.forename: O
authors.initials: O
authors.lastname: Agbaji
authors.forename: P
authors.initials: P
authors.lastname: Agaba
authors.forename: C
authors.initials: C
authors.lastname: Akolo
authors.forename: B
authors.initials: B
authors.lastname: Inuwa
authors.forename: Zuweira
authors.initials: Z
authors.lastname: Hassan
authors.forename: L
authors.initials: L
authors.lastname: Akintunde
authors.forename: B
authors.initials: B
authors.lastname: Badung
authors.forename: M
authors.initials: M
authors.lastname: Muazu
authors.forename: M
authors.initials: M
authors.lastname: Danang
authors.forename: G
authors.initials: G
authors.lastname: Imade
authors.forename: J Louis
authors.initials: JL
authors.lastname: Sankale
authors.forename: Phyllis
authors.initials: P
authors.lastname: Kanki
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D023801:Directly Observed Therapy / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010349:Patient Compliance; D012367:RNA, Viral / Q000097:blood; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral