Marginal Structural Models to Assess Delays in Second-Line HIV Treatment Initiation in South Africa.

ABSTRACT:

Background

South African HIV treatment guidelines call for patients who fail first-line antiretroviral therapy (ART) to be switched to second-line ART, yet logistical issues, clinician decisions and patient preferences make delay in switching to second-line likely. We explore the impact of delaying second-line ART after first-line treatment failure on rates of death and virologic failure.

Methods

We include patients with documented virologic failure on first-line ART from an observational cohort of 9 South African clinics. We explored predictors of delayed second-line switch and used marginal structural models to analyze rates of death following first-line failure by categorical time to switch to second-line. Cox proportional hazards models were used to examine virologic fai

SUBMITTER: Rohr JK 

PROVIDER: S-EPMC4993510 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature