Age, Social Support Linked to HIV Drug Adherence
Posted on: Tuesday, 28 March 2006, 15:40 CST
By Will Boggs, MD
NEW YORK (Reuters Health) - Younger age, lack of social support, and complex regimens contribute to poor adherence to antiretroviral therapy among patients with HIV infection.
Adherence to antiretroviral drug regimens is important and treatment needs to be closely monitored for indications of disease progression, such as an increase in viral load and a decrease in CD4 cell levels, Dr. Sabina De Geest from University of Basel, Switzerland told Reuters Health.
De Geest and colleagues used data from the Swiss HIV Cohort Study to determine the prevalence of self-reported adherence to antiretroviral therapy and to explore relationships among socioeconomic, patient, and systematic factors related to adherence.
Nearly one third of patients admitted missing at least one dose of medication in the four weeks preceding their questionnaire, the authors report in the Journal of Acquired Immune Deficiency Syndromes. About 15 percent reported missing at least two doses, and 7.1 percent said they took less than 95 percent of prescribed antiretroviral therapy doses.
Increases in missed doses correlated with increases in viral load and decreases in CD4 cell count.
Regardless of the definition of adherence used, patients who were younger, lived alone, had been on more previous antiretroviral therapy regimens, and received a boosted protease inhibitor regimen, were significantly more likely not to adhere to therapy in the previous four weeks, the researchers note.
Patients with optimal viral suppression in the previous six months and those with increases in CD4 counts of more than 50 cells per microliter were significantly more likely to have adhered to treatment, the report indicates.
"An interesting finding of this study was that we observed a center effect," De Geest said. "Adherence ranged among centers between 26.1 percent and 41.5 percent (overall: 31.1 percent). This observed center effect is a novel finding and suggests that system factors related to how care is organized and provided also are associated with non-adherence."
SOURCE: Journal of Acquired Immune Deficiency Syndromes, March 2006.
Source: REUTERS
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