Assuntos
Niacina/deficiência , Pelagra/diagnóstico , Pelagra/patologia , Adulto , Antituberculosos/efeitos adversos , Antituberculosos/uso terapêutico , Proteínas Alimentares/uso terapêutico , Quimioterapia Combinada , Humanos , Isoniazida/efeitos adversos , Isoniazida/uso terapêutico , Masculino , Niacinamida/uso terapêutico , Pelagra/terapia , Resultado do Tratamento , Tuberculose/tratamento farmacológico , Complexo Vitamínico B/uso terapêuticoRESUMO
Since 2004, the Malawi antiretroviral treatment (ART) program has provided a public health-focused system based on World Health Organization clinical staging, standardized first-line ART regimens, limited laboratory monitoring, and no patient-level monitoring of human immunodeficiency virus drug resistance (HIVDR). The Malawi Ministry of Health conducts periodic evaluations of HIVDR development in prospective cohorts at sentinel clinics. We evaluated viral load suppression, HIVDR, and factors associated with HIVDR in 4 ART sites at 12-15 months after ART initiation. More than 70% of patients initiating ART had viral suppression at 12 months. HIVDR prevalence (6.1%) after 12 months of ART was low and largely associated with baseline HIVDR. Better follow-up, removal of barriers to on-time drug pickups, and adherence education for patients 16-24 years of age may further prevent HIVDR.
