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This article has been withdrawn as it was published elsewhere and accidentally duplicated. The original article can be seen here: 10.1108/14664100010343971. When citing the article, please cite: Javier Ena, Concepción Benito, (2000), “Achieving plasma HIV RNA below the level of detection in clinical practice”, British Journal of Clinical Governance, Vol. 5 Iss 2 pp. 100 - 105.

Aims to assess the impact of a day‐care center (DCC) on hospital bed usage by HIV‐infected patients. Reviews the medical records of 710 hospital admissions of HIV‐infected patients admitted to two Spanish hospitals, one of them with a DCC, over a three‐year period. The proportion of unnecessary admissions was significantly higher in the hospital without a DCC. The rate of hospital admissions among patients who were admitted to hospital was also greater in the hospital without a DCC, as well as the rate of admissions among patients on antiretroviral drugs. Concludes that the availability of a DCC improves the appropriateness of hospital admissions and decreases the number of hospitalizations in HIV‐infected patients.

Clinical trials have shown that highly active antiretroviral therapy (HAART) reduces plasma HIV RNA below the detection level in up to 90 per cent of patients. To assess the independent predictors that are associated with achieving undetectable plasma HIV RNA in the daily clinical practice, we carried out a retrospective study. Among 106 HIV‐infected patients treated with HAART, 63 (59 per cent) achieved undetectable plasma HIV RNA (less than 400 copies/ml) at their last visit. Adherence with HAART (greater than 80 per cent of prescribed dose) was self‐reported by 81 patients (76 per cent). Independent predictors of achieving undetectable plasma HIV RNA were: self‐reported adherence to therapy (Odds ratio [OR] 11.79, 95 per cent Confidence intervals [CI]: 3.55‐33.17, p = 0.0001) and lack of previous antiretroviral therapy (OR: 3.12, 95 per cent CI: 1.09‐8.96, p = 0.03). The efficacy of antiretroviral therapy observed in the daily clinical practice was noticeably lower than that reported in clinical trials. Patient adherence with prescribed HAART and lack of previous antiretroviral therapy are important factors related to successful therapy in the real world.