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: | Noorjehan Abdul Magid, Maria Cristina Marazzi, Pasquale Narciso, Massimo Magnano San Lio, Riccardo Carbini, Ines Zimba, Sandro Mancinelli, P Germano, Leonardo Palombi, Elsa Renzi, Giovanni Guidotti |
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| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
antiretrovirus agent
RNA directed DNA polymerase inhibitor acquired immune deficiency syndrome adult article automation controlled study drug cost economic aspect female health program highly active antiretroviral therapy human major clinical study male malnutrition Mozambique observational study outcome assessment patient compliance pill primary health care priority journal proportional hazards model prospective study reliability sensitivity and specificity validity virus load evaluation health services research Human immunodeficiency virus infection methodology middle aged statistics validation study Adult Antiretroviral Therapy Highly Active Female Health Services Research HIV Infections Humans Male Middle Aged Patient Compliance Prospective Studies Reverse Transcriptase Inhibitors Sensitivity and Specificity Viral Load Settore MED/42 - Igiene Generale e Applicata Prospective cohort study Infectious Diseases Pill Viral disease Viral load Microbiology (medical) medicine.medical_specialty Antiretroviral Therapy Acquired immunodeficiency syndrome (AIDS) Internal medicine medicine Highly Active business.industry medicine.disease Surgery Regimen Clinical research Observational study business |
| Popis: | 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.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.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%) had95% treatment adherence; of those 284 patients, 274 (96.5%) had a final viral load1000 copies/mL. A Cox proportional hazards analysis revealed that the relationship between95% treatment adherence and the final viral load was closer than that between90% treatment adherence and viral load.Treatment adherence95% 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: | OpenAIRE |
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