Module 5: Management Of Employees With HIV/AIDS At Primary Level - Anti-Retroviral Therapy: The Khayelitsha Experience

RESULTS FROM KHAYELITSHA:

Some of the results after 24 months of providing ART in Khayelitsha are provided:

Survival:

This graph shows that approximately 85% of patients on ART in Khayelitsha have survived to 18 months.

This graph shows that the mortality is higher in those with a CD cell count < 50 cells per µl at initiation of HAART.

It is important to encourage HIV testing and to diagnose HIV early. It is best to start HAART before the CD4 cell count falls too low (in relation to 200). The table below shows the increase in the mean weight and CD4 cell count of the cohort at different time intervals compared to the time of initiation of HAART as well as the presence of an undetectable viral load. The challenge is now to ensure longterm adherence, when patients are well and have been on HAART for more than 12 months.

Safety:

The results shown in the table below indicate that HAART is safe, as the number of changes in therapy due to side effects are low. Most side effects occur early.

Morbidity:

The figure above shows that there is a 63% decrease in the incidence of TB and a 68% decrease in candidiasis.

Self-reported adherence:

The data shown below are preliminary results of self-reported adherence from May 2002 to Aug 2003,1, 3, and 12 months after initiation of HAART:

The patients who reported as being consistently poor or moderate: 1.3 % at 3 months and 2.2 % at 12 months.

Workplace health services:

Workplace Health Services are often ideally placed to support and monitor workers on HAART.