Study finds nurse-monitored antiretroviral therapy non-inferior to doctor-monitored care
WEDNESDAY, June 16 (HealthDay News) -- Nurse-monitored combination antiretroviral therapy (ART) in HIV-positive patients appears to be as effective and safe as doctor-monitored therapy, according to a non-inferiority study published online June 16 in The Lancet.
In the Comprehensive International Program for Research in AIDS in South Africa study, Ian Sanne, M.D., of the University of the Witwatersrand in Johannesburg, South Africa, and colleagues randomized 812 HIV-positive patients with a CD4 cell count of less than 350 cells per µL or World Health Organization stage 3 or 4 disease to nurse-monitored or doctor-monitored ART management between 2005 and 2007.
The researchers found that 371 patients (46 percent) experienced treatment failure: 48 percent in the nurse-monitored group and 44 percent in the doctor-monitored group. In addition, after a median follow-up of 120 weeks, deaths (10 versus 11), virological failures (44 versus 39), toxicity failures (68 versus 66), and program loses (70 versus 63) were similar in the nurse-monitored group compared to the doctor-monitored group, respectively.
"In conclusion, primary health care nurses were non-inferior to doctors in monitoring of first-line ART in a public health ART program in South Africa," the authors write. "The results of this study lend support to the expanded access to treatment with use of models of task shifting in primary health care."
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