Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
The New York Times - May 19, 2009
Donald G. Mcneil Jr.
Scientists from Makerere University's hospital in Kampala, Uganda, along with American and Belgian scientists, have developed a formula, based on close questioning of patients, for predicting which ones are most likely to have treatment failure.
Their methods, described in The Journal of the International AIDS Society, appear to work better than current World Health Organization guidelines, which are based on clinical signs of advancing disease and a CD4 count, a technique easier and less expensive than viral load tests.
The doctors questioned 496 patients about how often they had taken their pills in the last three days, the last four weeks and since they began taking them; they also asked whether the patients had ever missed two days' worth. They asked whether patients had ever paid for treatment and whether women had ever had single-dose nevirapine to protect new babies. They also asked about weight loss and rashes. Blood samples were taken for CD4 counts.
Having ever missed treatment for two days, and having ever had a 30 percent drop in CD4 count (a white blood cell measure that indicates AIDS progression) predicted treatment failure, the researchers found. They suggested that viral load testing, if available, be done on those patients first.
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