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Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011

OBJECTIVE: We evaluated the sensitivity and specificity of the WHO immunological criteria for detecting antiretroviral therapy (ART) treatment failure in a cohort of Vietnamese patients. We conducted a stratified analysis to determine the effects of BMI, peer support, adherence to antiretroviral (AR...

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Autores principales: Le, Nicole K., Riggi, Emilia, Marrone, Gaetano, Vu, Tam Van, Izurieta, Ricardo O., Nguyen, Chuc Kim Thi, Larsson, Mattias, Do, Cuong Duy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587312/
https://www.ncbi.nlm.nih.gov/pubmed/28877173
http://dx.doi.org/10.1371/journal.pone.0182688
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author Le, Nicole K.
Riggi, Emilia
Marrone, Gaetano
Vu, Tam Van
Izurieta, Ricardo O.
Nguyen, Chuc Kim Thi
Larsson, Mattias
Do, Cuong Duy
author_facet Le, Nicole K.
Riggi, Emilia
Marrone, Gaetano
Vu, Tam Van
Izurieta, Ricardo O.
Nguyen, Chuc Kim Thi
Larsson, Mattias
Do, Cuong Duy
author_sort Le, Nicole K.
collection PubMed
description OBJECTIVE: We evaluated the sensitivity and specificity of the WHO immunological criteria for detecting antiretroviral therapy (ART) treatment failure in a cohort of Vietnamese patients. We conducted a stratified analysis to determine the effects of BMI, peer support, adherence to antiretroviral (ARV) drugs, age, and gender on the sensitivity and specificity of the WHO criteria. METHODS: We conducted a retrospective cohort study of 605 HIV-infected patients using data previously collected from a cluster randomized control trial study. We compared the sensitivity and specificity of CD4(+) counts to the gold standard of virologic testing as a diagnostic test for ART failure at different time points of 12, 18, and 24 months. RESULTS: The sensitivity [95% confidence interval (CI)] of the WHO immunological criteria based on a viral load ≥ 1000 copies/mL was 12% (5%-23%), 14% (2%-43%), and 12.5% (2%-38%) at 12, 18, and 24 months, respectively. In the same order, the specificity was 93% (90%-96%), 98% (96%-99%), and 98% (96%-100%). The positive predictive values (PPV) at 12, 18, and 24 months were 22% (9%-40%), 20% (3%-56%), and 29% (4%-71%); the negative predictive values (NPV) at the same time points were 87% (84%-90%), 97% (95%-98%), and 96% (93%-98%). The stratified analysis revealed similar sensitivities and specificities. CONCLUSION: The sensitivity of the WHO immunological criteria is poor, but the specificity is high. Although testing costs may increase, we recommend that Vietnam and other similar settings adopt viral load testing as the principal method for determining ART failure.
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spelling pubmed-55873122017-09-15 Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011 Le, Nicole K. Riggi, Emilia Marrone, Gaetano Vu, Tam Van Izurieta, Ricardo O. Nguyen, Chuc Kim Thi Larsson, Mattias Do, Cuong Duy PLoS One Research Article OBJECTIVE: We evaluated the sensitivity and specificity of the WHO immunological criteria for detecting antiretroviral therapy (ART) treatment failure in a cohort of Vietnamese patients. We conducted a stratified analysis to determine the effects of BMI, peer support, adherence to antiretroviral (ARV) drugs, age, and gender on the sensitivity and specificity of the WHO criteria. METHODS: We conducted a retrospective cohort study of 605 HIV-infected patients using data previously collected from a cluster randomized control trial study. We compared the sensitivity and specificity of CD4(+) counts to the gold standard of virologic testing as a diagnostic test for ART failure at different time points of 12, 18, and 24 months. RESULTS: The sensitivity [95% confidence interval (CI)] of the WHO immunological criteria based on a viral load ≥ 1000 copies/mL was 12% (5%-23%), 14% (2%-43%), and 12.5% (2%-38%) at 12, 18, and 24 months, respectively. In the same order, the specificity was 93% (90%-96%), 98% (96%-99%), and 98% (96%-100%). The positive predictive values (PPV) at 12, 18, and 24 months were 22% (9%-40%), 20% (3%-56%), and 29% (4%-71%); the negative predictive values (NPV) at the same time points were 87% (84%-90%), 97% (95%-98%), and 96% (93%-98%). The stratified analysis revealed similar sensitivities and specificities. CONCLUSION: The sensitivity of the WHO immunological criteria is poor, but the specificity is high. Although testing costs may increase, we recommend that Vietnam and other similar settings adopt viral load testing as the principal method for determining ART failure. Public Library of Science 2017-09-06 /pmc/articles/PMC5587312/ /pubmed/28877173 http://dx.doi.org/10.1371/journal.pone.0182688 Text en © 2017 Le et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Le, Nicole K.
Riggi, Emilia
Marrone, Gaetano
Vu, Tam Van
Izurieta, Ricardo O.
Nguyen, Chuc Kim Thi
Larsson, Mattias
Do, Cuong Duy
Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011
title Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011
title_full Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011
title_fullStr Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011
title_full_unstemmed Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011
title_short Assessment of WHO criteria for identifying ART treatment failure in Vietnam from 2007 to 2011
title_sort assessment of who criteria for identifying art treatment failure in vietnam from 2007 to 2011
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587312/
https://www.ncbi.nlm.nih.gov/pubmed/28877173
http://dx.doi.org/10.1371/journal.pone.0182688
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