Knowledge Item: CA-Medical Outcomes-49
Viral Load Outcomes and Type of Project

Viral loads outcomes are examined to determine how many patients had clinically significant reductions in viral load as a function of participation in the Cooperative Agreement Projects.

Using as a criterion for success that the patient's viral load decreased at least .3 log units from the baseline assessment or that the viral load was undetectable at follow-up at the limit of the testing procedures equated across projects, 72.4 percent of the male patients and 60.2 percent of the female patients were found to have a clinically significant reduction in their viral load.

Using as a criterion for success that the patient's viral load decreased at least .5 log units from the baseline assessment or that the viral load was undetectable at follow-up at the limit of the testing procedures equated across projects, 70.6 percent of the male patients and 55.9 percent of the female patients were found to have a clinically significant reduction in their viral load.

While there was not a statistically significant difference for female patients among the outcome rates obtained in two different types of clinics, there was a statistically significant difference for males.

The following CHAIDs show results for five sites assessing Viral Load using the PCR method only (n = 513).

More Information:     CHAID and CHAID Diagram

The definition of outcome used in this Knowledge Item is based on the medical literature and the attempt to define what is considered a clinically significant outcome for a single patient in treatment. Note that a successful outcome is coded if the patient meets the medical criterion for positive change in health status at least one time during the course of the treatment episode. Other Knowledge Items (for example: Knowledge Item: CA-Medical Outcomes-14, -15, -18, -19, -22, -23) use a technique called Hierarchical Linear Modeling (HLM) which codes outcome as the overall trend in the patient's scores through the observed treatment episode. The HLM definition of a successful outcome is a stringent one that assumes that there is not a relapse, while the current definition acknowledges that in a progressive disease such as HIV/AIDS, there may be relapse to the baseline state even after a positive response to therapy.