Outcomes of an HIV cohort after a decade of comprehensive care at Newlands Clinic in Harare, Zimbabwe: TENART cohort

You might be living with HIV or taking care of people living with HIV and you wonder what the long term outcomes of antiretroviral therapy are. You're not alone. Such a description would inform people living with HIV as well as HIV programs on what can be achieved when people living with HIV are cared for in the same manner as done at Newlands Clinic which is supported by the Ruedi Luethy Foundation.

We looked into our patient files for patient information, particularly those who initiated therapy under our care between 2004 when our clinic was opened, and 2006. These are patients who had been recruited into care at least 10 years before the time of analysis which was at the end of 2016. Our model of care at Newlands Clinic includes the provision of antiretroviral medicines, adherence counselling (which helps people to consistently take their medicines), food security support for those unable to consistently access enough food and laboratory monitoring. During the time in question, patient care was mostly led by nurses with the support of doctors.

We analyzed records of 605 patients with an average age of 34 years at the time they started therapy. Most of them were female (67%). 474 (78.3%) were still in care at the end of 2016, while 59 (9.8%) had been transferred to other clinics, 45 (7.4%) were lost to follow up, 25 (4.1%) died and two stopped antiretroviral therapy. Sixty-six (11%) developed pulmonary tuberculosis while in care. Of the 474 that were still in care, 428 (90%) had undetectable viral loads, which is the main goal of antiretroviral therapy.

Our results show that the model of care for people living with HIV as implemented by Newlands Clinic can lead to highly successful treatment outcomes and a reduced number of deaths. They also show that pulmonary tuberculosis was an important opportunistic infection affecting over a tenth of these patients while in care.

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