Direct observation therapy-highly active antiretroviral therapy in a resource-limited setting: the use of community treatment support can be effective.
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.
Idoko
J A
JA
AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria. jonidoko@yahoo.com
Agbaji
O
O
Agaba
P
P
Akolo
C
C
Inuwa
B
B
Hassan
Zuweira
Z
Akintunde
L
L
Badung
B
B
Muazu
M
M
Danang
M
M
Imade
G
G
Sankale
J Louis
JL
Kanki
Phyllis
P
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
D019380:Anti-HIV Agents; D012367:RNA, Viral