Evaluating adherence to highly active antiretroviral therapy with use of pill counts and viral load measurement in the drug resources enhancement against AIDS and malnutrition program in Mozambique.
| Autor: | San Lio MM; Community of Sant'Egidio, Drug Resources Enhancement against AIDS and Malnutrition Program, Rome, Italy. massimo.magnano@gmail.com, Carbini R, Germano P, Guidotti G, Mancinelli S, Magid NA, Narciso P, Palombi L, Renzi E, Zimba I, Marazzi MC |
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| Jazyk: | angličtina |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2008 May 15; Vol. 46 (10), pp. 1609-16. |
| DOI: | 10.1086/587659 |
| Abstrakt: | Background: Maintaining treatment adherence among the growing number of patients receiving antiretroviral treatment in Africa is a dramatic challenge. The objective of our study was to explore the results of a computerized pill count method and to test the validity, sensitivity, and specificity of this method with respect to viral load measurement in an African setting. Methods: We performed a prospective, observational study involving patients who received first-line highly active antiretroviral therapy in Mozambique from 1 April 2005 through 31 March 2006. Enrolled patients had received treatment for at least 3 months before the study. For defining treatment adherence levels, pill counts were used, and the results were analyzed with viral load measurements at the end of the observation period. Results: The study involved 531 participants. During the 12 months of observation, 137 patients left the program or discontinued first-line therapy. Of the remaining 394 patients, 284 (72.1%) had >95% treatment adherence; of those 284 patients, 274 (96.5%) had a final viral load <1000 copies/mL. A Cox proportional hazards analysis revealed that the relationship between >95% treatment adherence and the final viral load was closer than that between >90% treatment adherence and viral load. Conclusions: Treatment adherence >95% maximizes the results of the nonnucleoside reverse-transcriptase inhibitor-based regimen. The pill count method appears to be a reliable and economic tool for monitoring treatment adherence in resource-limited settings. |
| Databáze: | MEDLINE |
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