The value of patient-reported adherence to antiretroviral therapy in predicting virologic and immunologic response
| Autor: | Judith S. Currier, Carol A. Kemper, Gildon N. Beall, Richard Haubrich, Michael P. Dubé, McCutchan Ja, Susan J. Little, Debra Johnson, Hwang Jy, Donald N. Forthal |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Chemotherapy
medicine.medical_specialty biology business.industry medicine.medical_treatment Immunology biology.organism_classification medicine.disease Infectious Diseases Acquired immunodeficiency syndrome (AIDS) Internal medicine Immunopathology Lentivirus medicine Immunology and Allergy Observational study Viral disease business Sida Viral load |
| Zdroj: | AIDS. 13:1099-1107 |
| ISSN: | 0269-9370 |
| DOI: | 10.1097/00002030-199906180-00014 |
| Popis: | Objective: To correlate self-reported antiretroviral adherence with virologic suppression. Design: Prospective observational study of adherence to therapy nested in a randomized comparative trial of frequent versus infrequent monitoring of plasma HIV RNA. Setting: Five university-affiliated HIV clinics. Patients: A group of 173 HIV-infected patients with a mean baseline CD4 count of 142 × 10 6 cells/l (range 3-515) of whom 164 and 119 completed adherence questionnaires at 2 and 6 months, respectively. Intervention: Individualized, unrestricted antiretroviral therapy. Measurements: Patients were classified into four groups by adherence to therapy in the previous 4 weeks (< 80%, 80-95%, 95-99%, 100%). Plasma HIV RNA levels and CD4 lymphocyte counts were measured bimonthly. Results: Recreational drug or alcohol use was associated with decreased adherence, whereas frequency of HIV RNA monitoring, demographic variables, (age, gender, education, and risk group) and stage of disease had no effect. Greater HIV suppression at 6 months was seen across four categories of increasing adherence (P = 0.009 for linear trend). Patients reporting < 80% adherence at 6 months had a 0.2 log 10 copies/ml increase in HIV RNA and a loss of 19 × 10 6 CD4 cells/l compared with a 1.1 log 10 copies/ml decrease in HIV RNA and an increase of 72 × 10 6 CD4 cells/l in those reporting 100% adherence (P = 0.02). Conclusion: Self-reported poor adherence (< 80%) and drug or alcohol use predicted non-response of HIV RNA at 6 months of antiretroviral therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|