The Impact of Different CD4 Cell-Count Monitoring and Switching Strategies on Mortality in HIV-Infected African Adults on Antiretroviral Therapy: An Application of Dynamic Marginal Structural Models

  title={The Impact of Different CD4 Cell-Count Monitoring and Switching Strategies on Mortality in HIV-Infected African Adults on Antiretroviral Therapy: An Application of Dynamic Marginal Structural Models},
  author={Deborah Ford and James M. Robins and M. L. Petersen and Diana M Gibb and Charles F. Gilks and Peter Mugyenyi and Heiner Grosskurth and James G Hakim and Elly Tebasooke Katabira and Abdel G. Babiker and A Sarah Walker and Paula Munderi and Geoffrey Kabuye and D. Nsibambi and Ronnie Kasirye and Eva Zalwango and M. Nakazibwe and Bernard Kikaire and Gladys Nassuna and Rita Massa and K. Fadhiru and M. Namyalo and A. Zalwango and Lillian Generous and P. Khauka and N. Rutikarayo and William Nakahima and Annet Mugisha and Jim Todd and Josh Levin and Sowedi Muyingo and Anthony Ruberantwari and Peter Hughes and Mark S. Aber and Cissy M. Kityo and Francis Ssali and Dinah Tumukunde and Tom Otim and Joseph Kabanda and Helen Musana and Junichi Akao and Hope Kyomugisha and Adolf Byamukama and Jesca Nsungwa Sabiiti and J. Komugyena and Priscilla Wavamunno and Stephen Mukiibi and A. Drasiku and Rose Byaruhanga and O. Labeja and Peter Awio and A. Namazzi and G. T. Bakeinyaga and H. Katabira and D. Abaine and J. Tukamushaba and W. Anywar and W. Ojiambo and E. Angweng and Scovia Murungi and W. Haguma and S. Atwiine and Aoife Reid and Ennie Chidziva and R. Bulaya-Tembo and Godfrey Musoro and Fabian Taziwa and Cleophas Chimbetete and L. Chakonza and A. Mawora and C. Muvirimi and G. Tinago and P. Svovanapasis and Mpepera B Simango and O. Chirema and J. Machingura and Shirley Mutsai and Misheck Phiri and T. Bafana and Allan Ronald and A. Kambungu and Fred Lutwama and A. Nanfuka and J. Walusimbi and Evelyn Nabankema and Ruth Nalumenya and T. Namuli and R. Kulume and Ibrahim Namata and L. Nyachwo and Alexander Florence and A. Kusiima and E. Lubwama and R. Nairuba and F. Oketta and E. Buluma and R. Waita and Henry Ojiambo and F. Sadik and J. M. Wanyama and Patrick Nabongo and Robert Ochai and D. Muhweezi and K. Boocock and C. Puddephatt and D. Winogron and Jennifer B Bohannon and Anahit Burke and Dianne Bray and Heinz Wilkes and Mary Rauchenberger and Steven Sheehan and Leon Peto and Kristal Taylor and Moira J Spyer and Alexander Ferrier and Bethany Naidoo and R. Nanfuka and C. Mufuka-Kapuya and Pontiano Kaleebu and Deenan Pillay and Vaux Robertson and Dave Yirrell and Stephano Tugume and Michael Chirara and Pauline Katundu and Nicaise Ndembi and Fred Lyagoba and David T Dunn and Ruth Goodall and Ashley J McCormick and Antonieta Medina Lara and Steve Foster and Jovita Amurwon and B. Nyanzi Wakholi and Joanita Kigozi and Lazarus Muchabaiwa and Margaret Muzambi and Ian Weller and Sylver Bahendeka and Molly Bassett and A. Chogo Wapakhabulo and J. H. M. Darbyshire and Brian George Gazzard and Jonathan Hakim and Aliang Latif and C. Mapuchere and Owen M. Mugurungi and C. Burke and Sarah A. Jones and China Newland and Saddar Rahim and Jane Rooney and Marcia Smith and Wendy B Snowden and J.-M. Steens and Andrew Breckenridge and Anna McLaren and Casey Hill and Jonathan A Matenga and Alyssa Pozniak and David M Serwadda and T. Peto and Adrian Palfreeman and Margaret Borok},
  booktitle={American journal of epidemiology},
In Africa, antiretroviral therapy (ART) is delivered with limited laboratory monitoring, often none. In 2003-2004, investigators in the Development of Antiretroviral Therapy in Africa (DART) Trial randomized persons initiating ART in Uganda and Zimbabwe to either laboratory and clinical monitoring (LCM) or clinically driven monitoring (CDM). CD4 cell counts were measured every 12 weeks in both groups but were only returned to treating clinicians for management in the LCM group. Follow-up… CONTINUE READING
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Cost effectiveness analysis of clinically driven versus routine laboratory monitoring of antiretroviral therapy in Uganda and Zimbabwe

  • A Medina Lara, J Kigozi, J Amurwon
  • PLoS One
  • 2012
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