a clinical prediction score in addition to who criteria for anti-retroviral treatment failure in resource-limited settings - experience from lesotho临床预测分数除了标准的抗逆转录病毒治疗失败在资源有限的环境中,体验从莱索托.pdfVIP

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a clinical prediction score in addition to who criteria for anti-retroviral treatment failure in resource-limited settings - experience from lesotho临床预测分数除了标准的抗逆转录病毒治疗失败在资源有限的环境中,体验从莱索托.pdf

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a clinical prediction score in addition to who criteria for anti-retroviral treatment failure in resource-limited settings - experience from lesotho临床预测分数除了标准的抗逆转录病毒治疗失败在资源有限的环境中,体验从莱索托

A Clinical Prediction Score in Addition to WHO Criteria for Anti-Retroviral Treatment Failure in Resource-Limited Settings - Experience from Lesotho 1 2 2 3 4 Niklaus Daniel Labhardt *, Thabo Lejone *, Matse’liso Setoko , Matalenyane Poka , Jochen Ehmer , 4 2 5 Karolin Pfeiffer , Patrice Zinga Kiuvu , Lutgarde Lynen 1 SolidarMed Lesotho, Seboche Hospital, Botha-Bothe, Lesotho, 2 Seboche Hospital, Botha-Bothe, Lesotho, 3 Lesotho Central Laboratory, Maseru, Lesotho, 4 SolidarMed Switzerland, Lucerne, Switzerland, 5 Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium Abstract Objective: To assess the positive predictive value (PPV) of a clinical score for viral failure among patients fulfilling the WHO- criteria for anti-retroviral treatment (ART) failure in rural Lesotho. Methods: Patients fulfilling clinical and/or immunological WHO failure-criteria were enrolled. The score includes the following predictors: Prior ART exposure (1 point), CD4-count below baseline (1), 25% and 50% drop from peak CD4-count (1 and 2), hemoglobin drop$1 g/dL (1), CD4 count,100/ml after 12 months (1), new onset papular pruritic eruption (1), and adherence,95% (3). A nurse assessed the score the day blood was drawn for viral load (VL). Reported confidence intervals (CI) were calculated using Wilsons method. Results: Among 1’131 patients on ART$6 months, 134 (11.8%) had immunological and/or clinical failure, 104 (78%) had blood drawn (13 died, 10 lost to follow-up, 7 did not show up). From 92 (88%) a result could be obtained (2 samples hemolysed, 10 lost). Out of these 92 patients 47 (51%) had viral failu