title: Antiretroviral Therapy Outcomes in Patients with Severe Mental Illness.
abstract: A retrospective cohort analysis was performed to describe outcomes and retention in care on antiretroviral therapy (ART) of 53 patients with severe mental illness (SMI). Diagnoses were psychosis secondary to HIV (24 patients), psychosis not otherwise specified (12), mania with or without psychosis (9), depression with psychotic features (4), and schizophrenia and bipolar mood disorder (2 each). The median baseline CD4 count was 66/mm(3) and viral load was 5.4 log10 copies/mL. Thirteen (25%) patients were lost to follow-up (10 within 6 months), 3 were transferred out, and 3 died. By week 96, 29 (85%) of 34 (64%) patients still in care had a viral load <400 copies/mL and 26 (76%) a viral load <25 copies/mL. Median CD4 count increased to 307/mm(3). Twenty-seven of 34 patients discontinued antipsychotic medication. Patients with SMI and advanced HIV infection responded well to ART. The first 6 months was important for retention in care.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa karstaedt@mweb.co.za.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Karstaedt
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Sadhna
authors.initials: S
authors.lastname: Kooverjee
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Lucille
authors.initials: L
authors.lastname: Singh
authors.affiliation: Department of Psychiatry, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Yasmien
authors.initials: Y
authors.lastname: Jeenah
authors.affiliation: Department of Psychiatry, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Gregory
authors.initials: G
authors.lastname: Jonsson
mesh_terms: D000328:Adult; D000368:Aged; D000480:Alkynes; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D048588:Benzoxazines / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000523:psychology*; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000276:immunology / Q000821:virology*; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D000480:Alkynes; D044966:Anti-Retroviral Agents; D048588:Benzoxazines; D003521:Cyclopropanes; C098320:efavirenz
keywords: Africa; HIV; antiretroviral treatment outcomes; efavirenz; mental illness