Makerere University

About: Makerere University is a education organization based out in Kampala, Uganda. It is known for research contribution in the topics: Population & Acquired immunodeficiency syndrome (AIDS). The organization has 7220 authors who have published 12405 publications receiving 366520 citations. The organization is also known as: Makerere University Kampala & MUK.

Treatment interruptions predict resistance in HIV-positive individuals purchasing fixed-dose combination antiretroviral therapy in Kampala, Uganda.

Abstract: The objective was to evaluate adherence treatment interruptions and outcomes in patients purchasing antiretroviral fixed-dose combination (FDC) therapy Ninety-seven participants were recruited into a prospective 24-week observational cohort study of HIV-positive antiretroviral-naive individuals initiating self-pay Triomune or Maxivir therapy in Kampala Uganda Adherence was measured by monthly structured interview unannounced home pill count and electronic medication monitors (EMM) Treatment interruptions were measured as continuous intervals greater than 48 h without opening the EMM The primary outcomes were survival with viral suppression below 400 copies/ml CD4 cell increases and genotypic drug resistance at 24 weeks The median baseline CD4 cell count was 56 cells/ml and median log10 copies RNA/ml was 554; mean adherence ranged from 82 to 95% for all measures but declined significantly over time In an intent-to-treat analysis 70 (72%) patients had an undetectable plasma HIV-RNA level at week 24 Sixty-two of 95 (65%) individuals with continuous EMM data had a treatment interruption of greater than 48 h Treatment interruptions accounted for 90% of missed doses None of 33 participants who did not interrupt treatment for over 48 h had drug resistance whereas eight of 62 (13%) participants who did interrupt therapy experienced drug resistance Antiretroviral resistance was seen in 8% of individuals and overall mortality was 10% at 24 weeks HIV-positive individuals purchasing generic FDC antiretroviral therapy have high rates of adherence and viral suppression low rates of antiretroviral resistance and robust CD4 cell responses Adherence is an important predictor of survival with full viral suppression Treatment interruptions are an important predictor of drug resistance (authors)

Cost-Effectiveness of Serum Cryptococcal Antigen Screening to Prevent Deaths among HIV-Infected Persons with a CD4+ Cell Count ≤100 Cells/μL Who Start HIV Therapy in Resource-Limited Settings

Abstract: died within 2 months of ART initiation. The number needed to test and treat with CRAG screening and fluconazole to prevent 1 CM case is 11.3 (95% CI, 7.9‐17.1) at costs of $190 (95% CI, $132‐$287). The number needed to test and treat to save 1 life is 15.9 (95% CI, 11.1‐24.0) at costs of $266 (95% CI, $185‐$402). The cost per disability-adjusted life year saved is $21 (95% CI, $15‐$32). Conclusions. Integrating CRAG screening into HIV care, specifically targeting people with severe immunosuppression (CD4 + cell count 100 cells/mL) should be implemented in treatment programs in resource-limited settings. ART alone is insufficient treatment for CRAG-positive persons.