Abstract
Laboratory monitoring for toxicity among patients receiving antiretroviral therapy (ART) in less-developed settings is technically challenging and consumes significant resources. We conducted a cohort study of the 1800 adult patients who initiated ART at the Haitian Study Group for Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) in Haiti from 2003 to 2006, using baseline data to establish the prevalence and using follow-up data to establish the incidence of hepatitis, renal insufficiency, hyperglycemia, anemia, neutropenia, and thrombocytopenia. We determined how frequently routine (not symptom-driven) testing detected significant laboratory abnormalities and calculated the cost per disability-adjusted life year (DALY) averted by detection of these events in the asymptomatic stage, compared with a strategy of symptom-prompted testing only. Forty-eight patients (3.5%) had severe anemia at baseline testing and consequently did not receive zidovudine. Fifty-three patients receiving zidovudine therapy developed severe anemia during follow-up (incidence, 2.5 cases/100 person-years). Monitoring for asymptomatic anemia with hematocrit testing was cost-saving at baseline and had a cost-effectiveness ratio of US$317/DALY averted...Continue Reading
References
Feb 1, 1991·Chest·M A SteeleR M DesPrez
Apr 15, 1990·The New England Journal of Medicine·P A VolberdingM S Hirsch
Sep 1, 1990·The American Review of Respiratory Disease
Dec 8, 1998·JAMA : the Journal of the American Medical Association
Jan 12, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Mark S SulkowskiRichard D Moore
Jun 29, 2002·The Journal of Infectious Diseases·Ferdinand W N M WitJoep M A Lange
Mar 11, 2003·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Massimo PuotiUNKNOWN HIV-HCV Co-Infection Study Group
Apr 3, 2003·HIV Clinical Trials·Luz Martín-CarboneroVincent Soriano
Oct 3, 2003·AIDS·W Phillip LawDavid A Cooper
Oct 3, 2003·AIDS·Monique M de MaatJos H Beijnen
Apr 20, 2004·Lancet·F van LethUNKNOWN 2NN Study team
Feb 18, 2005·The Journal of Infectious Diseases·Ian SanneFranck Rousseau
May 25, 2005·Archives of Internal Medicine·Todd T BrownAdrian S Dobs
Dec 2, 2005·The New England Journal of Medicine·Patrice SevereDaniel W Fitzgerald
Aug 10, 2006·The Journal of Antimicrobial Chemotherapy·Reto NueschUNKNOWN HIV-NAT Study Team
Sep 25, 2007·AIDS·Kenneth A FreedbergRochelle P Walensky
Sep 21, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ramnath SubbaramanNagalingeswaran Kumarasamy
Oct 16, 2007·Current Opinion in Hematology·Bertrand GodeauJames Bussel
Sep 24, 2008·Archives of Internal Medicine·Eran BendavidDouglas K Owens
Feb 12, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Serena P KoenigDaniel W Fitzgerald
Dec 17, 2009·Lancet·UNKNOWN DART Trial TeamE Katabira
Citations
Feb 26, 2013·AIDS·Babafemi TaiwoUNKNOWN CFAR Network of Integrated Clinical Systems (CNICS) Cohort Study
Sep 29, 2011·PLoS Medicine·Serena P KoenigBruce R Schackman
Mar 8, 2013·PloS One·Benson R KidenyaDaniel W Fitzgerald
Sep 26, 2014·BMC Infectious Diseases·Cavin Epie BekoloBasile Kollo
Mar 1, 2013·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Elizabeth L YanikUNKNOWN Center for Aids Research Network of Integrated Clinical Systems (CNICS) Cohort Study
Jan 1, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Jean W PapeWarren D Johnson
Jun 12, 2013·Journal of Pharmaceutical Sciences·Kelen C C SoaresJennifer Dressman
Oct 30, 2016·International Journal of STD & AIDS·Archana SinghGurdeep Buxi
Sep 25, 2018·Journal of Managed Care & Specialty Pharmacy·Richard E NelsonJoanne LaFleur
Feb 15, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Shilpa SayanaHomayoon Khanlou
Sep 1, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Charles B HolmesJohn M Blandford
Dec 15, 2010·Current Opinion in Infectious Diseases·A Sarah Walker, Diana M Gibb
Oct 17, 2019·PloS One·Kate SimeonPaul K Drain
Jul 2, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Cynthia RiviereSerena P Koenig