Objective: To compare the clinical outcome in Naïve human immunodeficiency virus (HIV)-infected patients on antiretroviral therapy between the multidisciplinary care team approach and usual care.

Material and Method: The study design was carried out in two groups of HIV-infected patients initially receiving antiretroviral regimen at Infectious Diseases Out-patient Clinic, Songklanagarind Hospital. First group received the usual care (The standard care before the introduction of multi-disciplinary care) during January to December 2009 and the second group received the multi-disciplinary care team (physicians, pharmacists and nurses) for promoting and monitoring treatment adherence during January to December 2010. Moreover, consultation on telephone was given whenever there were problems. We analyzed the CD4 T lymphocyte and viral load after taking anti-retroviral 6 months and 1 year between two groups. In addition we identified of factors affecting the CD4 T lymphocyte and viral load after taking antiretroviral for 6 months and for 1 year.

Results: Sixty-seven patients received the usual care and sixty-six received multidisciplinary care, respectively. Forty percent and 39% in the two groups were females, and the average ages were 41.3 (standard deviation; S.D.=10.1) and 37.3 (S.D.=9.4) years, respectively. The initial CD4 T lymphocyte in the two groups were approximately 142 (S.D.=121) and 144 (S.D.=112) cells/mm³, respectively. There were no significant patient demographics in the two groups (p>0.05). After one-year of therapy, the CD4 T lymphocyte level in the patient receiving the multidisciplinary care team was significantly higher than the usual care groups (p<0.05). The ratio of virologic suppression after 6-month and 1-year therapy was significantly higher in the patient were receiving the multidisciplinary care team than in the receiving the usual care (p<0.05). Using multiple regression analysis, the success rate at month 6 and year 1 of the patient receiving the multidisciplinary care team was significantly higher than in the receiving the usual care. [odd ratio; OR=16.98; 95% confidence interval (95% CI) 1.65-175.15 และ OR=18.29; 95% CI 2.13-157.04 respectively]

Conclusions: The Naïve HIV-infected patients receiving the multidisciplinary care team with promoting and monitoring treatment adherence had improve clinical outcomes and lower drug resistance.