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The risk of interruption in care or death was three times higher for patients who discontinued cART because of drug stock-outs, but stock-out-related cART modifications did not affect patient outcomes.
Among the 975 patients who were on cART for at least six months, stock-out-related cART discontinuations increased the risk of interruption in care or death (adjusted hazard ratio [HR], 2.83; 95%CI, 1.25 6.44) but cART modifications did not (adjusted HR, 1.21; 95%CI, 0.46 3.16).
The objectives of this study are to assess the frequency of cART stock-outs in three major HIV care centers in Abidjan, Côte d'Ivoire; to determine whether stock-outs led to cART modifications or discontinuations; and to study the impact of stock-out-related modifications or discontinuations on retention in care and mortality.
Factors associated with cART modifications at 12 months and factors associated with an HIV viral load of <50 copies/mL at 12 months were assessed by univariate and multivariate logistic regression modeling.
Factors associated with cART modifications at 12 months and factors associated with an HIV viral load <50 copies/mL at 12 months were assessed by univariate and multivariate logistic regression modeling.
In previous analyses we have shown that toxicities were the driving force for first-line cART modifications and/or interruptions which were highly incident in our cohort especially during the first year of cART [ 32].
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These data included AIDS-defining events, cART modification or discontinuation, and cause of modification or discontinuation.
We used a multivariate Cox proportional hazard regression model to examine the association between interruption in care or death and stock-out-related cART modification or discontinuation.
Cary, North Carolina, USA We conducted a sensitivity analysis on the definition of drug stock-out, because the reason for cART modification or discontinuation was not always noted in the medical record.
A sensitivity analysis was performed by excluding simplification of treatment from other causes of cART modification.
Conversely, the proportion of patients reporting cART modification during the first year decreased from 52.1%too 22.6% (P < .001).001
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