Simple adherence assessments to predict virologic failure among HIV-infected adults with discordant immunologic and clinical responses to antiretroviral therapy.

AIDS Research and Human Retroviruses
Jason D GoldmanBenjamin H Chi

Abstract

We evaluated the association between two antiretroviral therapy (ART) adherence measurements--the medication possession ratio (MPR) and patient self-report--and detectable HIV viremia in the setting of rapid service scale-up in Lusaka, Zambia. Drug adherence and outcomes were assessed in a subset of patients suspected of treatment failure based on discordant clinical and immunologic responses to ART. A total of 913 patients were included in this analysis, with a median time of 744 days (Q1, Q3: 511, 919 days) from ART initiation to viral load (VL) measurement. On aggregate over the period of follow-up, 531 (58%) had optimal adherence (MPR > or =95%), 306 (34%) had suboptimal adherence (MPR 80-94%), and 76 (8%) had poor adherence (MPR <80%). Of the 913 patients, 238 (26%) had VL > or =400 copies/ml when tested. When compared to individuals with optimal adherence, there was increasing risk for virologic failure in those with suboptimal adherence [adjusted relative risk (ARR): 1.3; 95% confidence interval (CI): 1.0, 1.6] and those with poor adherence (ARR: 1.7; 95% CI: 1.3, 2.4) based on MPR. During the antiretroviral treatment course, 676 patients (74%) reported no missed doses. The proportion of patients with virologic failure d...Continue Reading

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Citations

Mar 12, 2010·American Journal of Epidemiology·Benjamin H ChiJeffrey S A Stringer
Jun 24, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Benjamin H ChiJeffrey S A Stringer
Sep 5, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·John R KoetheJeffrey S A Stringer
Dec 17, 2009·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Benjamin H ChiJeffrey S A Stringer
Aug 28, 2010·Journal of the International Association of Physicians in AIDS Care : JIAPAC·John FarleyWilliam Blattner
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Apr 16, 2016·Medicine·Woldesellassie M BezabheGregory M Peterson
Sep 24, 2015·BMC Pediatrics·Francis Ateba NdongoUNKNOWN ANRS-PEDIACAM study group
Nov 26, 2014·Journal of the International Association of Providers of AIDS Care·Lassane KaboreMichael J Mugavero
Jan 20, 2017·Tropical Medicine & International Health : TM & IH·Neo Christopher ChungBenjamin H Chi
Sep 1, 2017·AIDS Research and Human Retroviruses·Dilek Yildiz SevgiFehmi Tabak
Aug 23, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Benjamin H ChiJeffrey S A Stringer
Nov 17, 2016·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Peter BockNathan Ford
Jan 1, 2014·Health Psychology and Behavioral Medicine·Ryan CookDeborah L Jones

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