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Hematologic, Hepatic, Renal, and Lipid Laboratory Monitoring After Initiation of Combination Antiretroviral Therapy in the United States, 2000–2010

Yanik, Elizabeth L. ScM*; Napravnik, Sonia PhD, MPH*,†; Ryscavage, Patrick MD; Eron, Joseph J. MD*,†; Koletar, Susan L. MD§; Moore, Richard D. MD, MHS; Zinski, Anne PhD; Cole, Stephen R. PhD*; Hunt, Peter MD#; Crane, Heidi M. MD, MPH**; Kahn, James MD††; Mathews, William C. MD, MPH‡‡; Mayer, Kenneth H. MD§§; Taiwo, Babafemi O. MBBS‖‖on behalf of the Center for Aids Research Network of Integrated Clinical Systems (CNICS) Cohort Study

JAIDS Journal of Acquired Immune Deficiency Syndromes: June 1st, 2013 - Volume 63 - Issue 2 - p 216–220
doi: 10.1097/QAI.0b013e31828d69f1
Brief Report: Clinical Science

Abstract: We assessed laboratory monitoring after combination antiretroviral therapy initiation among 3678 patients in a large US multisite clinical cohort, censoring participants at last clinic visit, combination antiretroviral therapy change, or 3 years. Median days (interquartile range) to first hematologic, hepatic, renal, and lipid tests were 30 (18–53), 31 (19–56), 33 (20–59), and 350 (96–1106), respectively. At 1 year, approximately 80% received more than 2 hematologic, hepatic, and renal tests consistent with guidelines. However, only 40% received 1 or more lipid tests. Monitoring was more frequent in specific subgroups, likely reflecting better clinic attendance or clinician perception of higher susceptibility to toxicities.

Departments of *Epidemiology, and

Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;

Department of Medicine, University of Maryland, Baltimore, MD;

§Department of Medicine, Ohio State University, Columbus, OH;

Department of Medicine, Johns Hopkins University, Baltimore, MD;

Department of Medicine, University of Alabama at Birmingham, Birmingham, AL;

#Department of Medicine, University of California at San Francisco, San Francisco, CA;

**Department of Medicine, University of Washington, Seattle, WA;

††Department of Medicine, Stanford University, Stanford, CA;

‡‡Department of Medicine, University of California at San Diego, San Diego, CA;

§§Fenway Community Health Center, Boston, MA; and

‖‖Department of Medicine, Northwestern University, Chicago, IL.

Correspondence to: Elizabeth L. Yanik, ScM, Department of Epidemiology, University of North Carolina, 130 Mason Farm Rd, Chapel Hill, NC 27517 (e-mail:

Grants R24-AI067039, P30-AI50410, 5T32-AI007001-35 from the National Institutes of Health; and R01-HS018731 from the Agency for Healthcare Research and Quality.

Portions of the data were previously presented at IDWeek, October 17–21, 2012, San Diego, CA.

E.L.Y., B.O.T., and S.N. led the conception and design of this study, contributed to data acquisition and interpretation, prepared the initial draft of the article, had full access to all the data in the study, and took final responsibility for the decision to submit for publication. J.J.E., P.R., and S.L.K. substantively contributed to the conception and design of this study, data acquisition and/or interpretation, and provided critical revision of the article. Remaining authors provided substantial contributions to the study design, data acquisition and/or interpretation of data, and provided critical revision of the article. All authors approved the final version of the article.

S.N. has received grant support from Pfizer, Bristol-Myers Squibb and Merck; B.O.T. has served as an advisor and/or received research support (to Northwestern University) from Janssen, GlaxoSmithKline, and ViiV; J.J.E is a consultant to Bristol Myers Squibb, GlaxoSmithKline, Merck, ViiV, and Janssen, and has received research support (to UNC) from GlaxoSmithKline, Bristol Myers Squibb, and Merck. All remaining authors have no conflicts of interest to disclose.

The funding sources did not participate in the study design; collection, analysis, and interpretation of data; in the writing of the article; or in the decision to submit the article for publication.

Received October 30, 2012

Accepted February 12, 2013

© 2013 by Lippincott Williams & Wilkins