Abstract
With the objective of analyzing the efficacy of directly observed treatment (DOT) of HIV infection in the management of severely immunodepressed patients, this method was examined in individuals cared for in two social welfare facilities for HIV-infected persons and compared to self-administered therapy in outpatients. Forty-seven patients with registered HIV infection, stage C, were assigned to DOT for 9 months, the majority of whom had previously received antiretroviral therapy. A group of 51 HIV-infected outpatients, who attended day clinics attached to the reference hospitals, served as a comparison group. Together with increases in weight (9.2±7.5 kg) and Karnofsky scores (16.9±12.2) in the DOT group, a significant improvement of surrogate markers, such as CD4+ T-cell counts (increase in DOT group, 113.4±151.0 cells/µl; control group, −2.8±114.1 cells/µl; P<0.001) and HIV load (decrease in DOT group, −1.7±2.3 log10 copies/ml; control group, −0.4±1.5 log10 copies/ml; P<0.01) was detected in the DOT group. Morbidity and mortality were similar in both groups. The results indicate that such welfare facilities provide a useful framework not only for social objectives but also for healthcare purposes.
Similar content being viewed by others
References
Stone VE (2001) Strategies for optimizing adherence to highly active anti-retroviral therapy: lessons from research and clinical practice. Clin Infect Dis 33:865–872
Woodward WC (1996) Should directly observed therapy be considered for treatment of HIV? JAMA 276:1956
Sherer R (1998) Adherence and antiretroviral therapy in injection drug users. JAMA 280:567–568
Sorensen JL, Mascovich A, Wall TL, DePhilippis D, Batki SL, Chesney M (1998) Medication adherence strategies for drug abusers with HIV/AIDS. AIDS Care 10:297–312
Mitty JA, Mckenzie M, Stenzel M, Flanigan T, Carpenter CCJ (1999) Modified directly observed therapy for treatment of human immunodeficiency virus. JAMA 282:1334
Chaulk CP, Kazandijian VA (1998) Directly observed therapy for treatment completion of pulmonary tuberculosis. JAMA 279:943–948
Babudiere S, Aceti A, D’Offizi GP, Carbonara S, Starnini G (2000) Directly observed therapy to treat HIV infection in prisoners. JAMA 284:179–180
Lanzafame M, Trevenzoli M, Cattelan AM, Lazzarini L, Vento Ercole Concia S (2000) Directly observed therapy in HIV therapy: a realistic perspective? J Acquir Immune Defic Syndr 25:200–201
Mitty JA, Stone VE, Sands M, Macalino G, Flanigan T (2002) Directly observed therapy for the treatment of people with human immunodeficiency virus infection: a work in progress. Clin Infect Dis 34:984–990
Farmer P, Leandre F, Mukherjee JS, Claude M, Nevil P, Smith-Fawzi MC, Koenig SP, Castro A, Becerra MC, Sachs J, Attaran A, Kim JY (2001) Community-based approaches to HIV treatment in resource-poor setting. Lancet 358:404–409
Carpenter CC, Fischl MA, Hammer SM, Hirsch MS, Jacobsen DM, Katzenstein DA, Montaner JS, Richman DD, Saag MS, Schooley RT, Thompson MA, Vella S, Yeni PG, Volberding PA (1998) Antiretroviral therapy for HIV infection in 1998: updated recommendations of the International AIDS Society-USA Panel. JAMA 280:78–86
Carpenter CC, Cooper DA, Fischl MA, Gatell JM, Gazzard BG, Hammer SM, Hirsch MS, Jacobsen DM, Katzenstein DA, Montaner JS, Richman DD, Saag MS, Schechter M, Schooley RT, Thompson MA, Vella S, Yeni PG, Volberding PA (2000) Antiretroviral therapy in adults: updated recommendations of the International AIDS Society-USA Panel. JAMA 283:2936–2937
McCabe WR, Jackson GG (1962) Gram-negative bacteremia. I. Etiology and ecology. Arch Intern Med 110:847–855
Centers for Diseases Control (1992) 1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR 41:RR-17
Knobel H, Alonso J, Casado JL, Collazos J, Gonzalez J, Ruiz I, Kindelan JM, Carmona A, Juega J, Ocampo A, GEEMA Study Group (2002) Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: The GEEMA Study. AIDS 16:605–613
López-Suárez A, Fernández-Gutiérrez del Álamo C, Pérez-Guzmán E, Girón-González JA (1998) Adherence to antiretroviral treatment in asymptomatic HIV-infected patients. AIDS 12:685–686
Deeks SG, Hecht FM, Swanson M, Elbeik T, Loftus R, Cohen PT, Grant RM (1999) HIV RNA and CD4 cell count response to protease inhibitor therapy in an urban AIDS clinic: response to both initial and salvage therapy. AIDS 13:F35–43
Torre D, Tambini R (2002) Antiretroviral drug resistance testing in patients with HIV-1 infection: a meta-analysis study. HIV Clin Trials 3:1–8
Ledergerber B, Egger M, Erard V, Weber R, Hirschel B, Furrer H, Battegay M, Vernazza P, Bernasconi E, Opravil M, Kaufmann D, Sudre P, Francioli P, Telenti A (1999) AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: The Swiss HIV Cohort Study. JAMA 282:2220–2226
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tinoco, I., Girón-González, J.A., González-González, M.T. et al. Efficacy of Directly Observed Treatment of HIV Infection: Experience in AIDS Welfare Homes. Eur J Clin Microbiol Infect Dis 23, 331–335 (2004). https://doi.org/10.1007/s10096-003-1099-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-003-1099-8