Time to treatment initiation and retrospective analysis of antiretroviral therapy outcomes among HIV-positive methadone maintenance therapy clients in primary health-care centers, Kuantan, Pahang

Aida Roziana Ramlan; Nor Ilyani Mohamed Nazar; Afidalina Tumian; Norny Syafinaz Ab Rahman; Dzawani Mohamad; Mat Sharil Abdul Talib; Khairul Faizan M Zakaria; Muhammad Azzim Izuddin; Nadia Akmal Zainal Abidin; Syarifah Syafiqah T Syed Manso; Wan Nur Khairiyah Wan Hassan

doi:10.4103/jpbs.JPBS_3_20

Journal of Pharmacy And Bioallied Sciences

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ORIGINAL ARTICLE

Year : 2020 | Volume : 12 | Issue : 6 | Page : 810-815

Time to treatment initiation and retrospective analysis of antiretroviral therapy outcomes among HIV-positive methadone maintenance therapy clients in primary health-care centers, Kuantan, Pahang

Aida Roziana Ramlan¹, Nor Ilyani Mohamed Nazar², Afidalina Tumian³, Norny Syafinaz Ab Rahman², Dzawani Mohamad⁴, Mat Sharil Abdul Talib⁵, Khairul Faizan M Zakaria⁶, Muhammad Azzim Izuddin⁷, Nadia Akmal Zainal Abidin⁸, Syarifah Syafiqah T Syed Manso⁹, Wan Nur Khairiyah Wan Hassan¹⁰
¹ Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; Department of Pharmacy, Hospital Tengku Ampuan Afzan, Ministry of Health Malaysia, Kuantan, Pahang, Malaysia
² Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
³ Kulliyyah of Engineering, International Islamic University Malaysia, Gombak, Selangor, Malaysia
⁴ Medical Department, Hospital Tengku Ampuan Afzan, Ministry of Health Malaysia, Kuantan, Pahang, Malaysia
⁵ Pharmacy Unit, Kurnia Health Clinic, Kuantan, Pahang, Malaysia
⁶ Pharmacy Unit, Paya Besar Health Clinic, Kuantan, Pahang, Malaysia
⁷ Pharmacy Unit, Bandar Kuantan Health Clinic, Kuantan, Pahang, Malaysia
⁸ Pharmacy Unit, Bukit Goh Health Clinic, Kuantan, Pahang, Malaysia
⁹ Pharmacy Unit, Jaya Gading Health Clinic, Kuantan, Pahang, Malaysia
¹⁰ Pharmacy Unit, Beserah Health Clinic, Kuantan, Pahang, Malaysia

Correspondence Address:
Dr. Nor Ilyani Mohamed Nazar
Department of Pharmacy Practice, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, Bandar Indera Mahkota Campus, 25200 Kuantan, Pahang.
Malaysia

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jpbs.JPBS_3_20

Introduction: Methadone maintenance therapy (MMT) program helped to improve access to antiretroviral therapy (ART) among people who inject drugs (PWID) with human immunodeficiency virus (HIV). However, the time to treatment initiation (TTI) and outcomes of ART intervention in this population have scarcely been analyzed. Objectives: The aim of this study was to analyze the TTI and outcomes of ART among MMT clients in primary health-care centers in Kuantan, Pahang. Materials and Methods: This was a retrospective evaluation of MMT clients from 2006 to 2019. The TTI was calculated from the day of MMT enrolment to ART initiation. The trends of CD4 counts and viral loads were descriptively evaluated. Cox proportional hazard model was used to analyze the survival and treatment retention rate. Results: A total of 67 MMT clients from six primary health-care centers were HIV-positive, of which 37 clients were started on ART. The mean TTI of ART was 27 months. The clients who were given ART had a mean CD4 count of 119 cells/mm³ at baseline and increased to 219 cells/mm³ after 6 months of ART. Only two patients (5.4%) in the ART subgroup had an unsuppressed viral load. The initiation of ART had reduced the risk of death by 72.8% (hazard ratio = 0.27, P = 0.024), and they are 13.1 times more likely to remain in treatment (P < 0.01). Conclusion: The TTI of ART was delayed in this population. MMT clients who were given ART have better CD4 and viral load outcomes, helped reduced death risk and showed higher retention rates in MMT program.

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