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A Two-stage Approach for Rapid Assessment of the Proportion Achieving Viral Suppression Using Routine Clinical Data.
Edwards, Jessie K; Donastorg, Yeycy; Zadrozny, Sabrina; Hileman, Sarah; Gómez, Hoisex; Seamans, Marissa J; Herce, Michael E; Ramírez, Edwin; Barrington, Clare; Weir, Sharon.
Afiliación
  • Edwards JK; From the Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Donastorg Y; Instituto Dermatológico y Cirugia de Piel, Santo Domingo, Dominican Republic.
  • Zadrozny S; Frank Porter Graham Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Hileman S; Independent, Chapel Hill, NC.
  • Gómez H; Instituto Dermatológico y Cirugia de Piel, Santo Domingo, Dominican Republic.
  • Seamans MJ; Department of Epidemiology, University of Los Angeles, Los Angeles, CA.
  • Herce ME; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Ramírez E; Servicio Nacional de Salud, Santo Domingo, Dominican Republic.
  • Barrington C; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Weir S; From the Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Epidemiology ; 33(5): 642-649, 2022 09 01.
Article en En | MEDLINE | ID: mdl-35648416
BACKGROUND: Improving viral suppression among people with HIV reduces morbidity, mortality, and transmission. Accordingly, monitoring the proportion of patients with a suppressed viral load is important to optimizing HIV care and treatment programs. But viral load data are often incomplete in clinical records. We illustrate a two-stage approach to estimate the proportion of treated people with HIV who have a suppressed viral load in the Dominican Republic. METHODS: Routinely collected data on viral load and patient characteristics were recorded in a national database, but 74% of patients on treatment at the time of the study did not have a recent viral load measurement. We recruited a subset of these patients for a rapid assessment that obtained additional viral load measurements. We combined results from the rapid assessment and main database using a two-stage weighting approach and compared results to estimates obtained using standard approaches to account for missing data. RESULTS: Of patients with recent routinely collected viral load data, 60% had a suppressed viral load. Results were similar after applying standard approaches to account for missing data. Using the two-stage approach, we estimated that 77% (95% confidence interval [CI] = 74, 80) of those on treatment had a suppressed viral load. CONCLUSIONS: When assessing the proportion of people on treatment with a suppressed viral load using routinely collected data, applying standard approaches to handle missing data may be inadequate. In these settings, augmenting routinely collected data with data collected through sampling-based approaches could allow more accurate and efficient monitoring of HIV treatment program effectiveness.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Límite: Humans País/Región como asunto: Republica dominicana Idioma: En Revista: Epidemiology Asunto de la revista: EPIDEMIOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Fármacos Anti-VIH Límite: Humans País/Región como asunto: Republica dominicana Idioma: En Revista: Epidemiology Asunto de la revista: EPIDEMIOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos