October 6, 2007
Welcome. This is Bonnie Goldman, Editorial Director of The Body PRO. I'm in San Diego at IDSA 2007, one of the year's HIV conferences. Right now, I'm in the poster session where researchers are standing in front of their posters. There's nothing like hearing the results of research directly from those who actually conducted the research. It is these women and men who are transforming HIV treatment and care. In this podcast, the researchers will introduce themselves and then summarize their study. After their summary, I'll ask a few questions.
My name is Ed Blanchard. I'm from Temple University Hospital. This study was basically an outpatient retrospectives chart review from our HIV patients.1 We looked at all the patients who were new to our clinic over three years, from 2003 to 2005. We weeded out those people who were naive to treatment, naive to antiretrovirals.
When we looked at them, we had about 169 of those people. Of those, we looked at how many were initiated on treatment, and what were their outcomes after one year of therapy in terms of how many people failed and how many people developed resistance while on therapy.
The conclusions were basically that: We started about 109 people on treatment over the course of one year and 38% of them had virologic success within that time period. We had about a 20% loss of follow-up rate. Weeding out those people for whom there was a loss of follow-up, we were left with 87 people. Of those 87, 47% had virologic success.
Is that considered a good percentage in this population?
Well, in general, the numbers have been better in terms of other studies -- people who have virologic success. But this was an inner-city clinic patient population, with different barriers to care. So it's hard to compare our population to the general, randomized control populations who are actually enrolled in a study. But this was all retrospective. So these people didn't necessarily know they were going to be in the study.
The baseline CD4 count was 120?
Yes, it was a pretty wide range, but the median was 120.
Why were the initial HAART regimens NNRTI [non-nucleoside reverse transcriptase inhibitor] based? I know this was a retrospective, but when you need to be pretty adherent ...
Most of ours actually were PI [protease inhibitor] based, which is not necessarily the norm, in terms of, we think that most people probably would be started more likely on an NNRTI. But because our population had different issues with compliance, with not taking their medications regularly, most of them actually ended up being more often than not started on a PI base. Because issues with developing resistance are less of an issue with them.
This was largely an African-American group?
Yes, about 86%.
What sort of adherence support is there in this clinic?
In terms of helping them keep adherent? Well, we have different supportive people in our clinic. We have nurse practitioners, we have Pharm. D.s who make separate appointments to see the patients, go through their medications, help them with pill bottles, remind them of their appointments, things like that. We have a social worker in our clinic, as well. The issue is just getting them to the clinic.
Is this is a Ryan White funded clinic?
Thank you very much.