BACKGROUND: Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance is essential to achieving long-term success. METHODS: A total of 150 subjects who had received antiretroviral therapy for at least 6 months completed a structured questionnaire and adherence assessment, and plasma human immunodeficiency virus (HIV) RNA levels were measured. Virologic failure was defined as an HIV RNA level >400 copies/mL; for patients with an HIV RNA level >1000 copies/mL, genotypic antiviral drug resistance testing was performed. Predictors were analyzed using bivariable and multivariable logistic regression models. RESULTS: A total of 23 (16%) of 150 subjects reported incomplete adherence. Sacrificing health care for other necessities (adjusted odds ratio [AOR], 19.8; P<.01) and the proportion of months receiving self-funded treatment (AOR, 23.5; P=.04) were associated with incomplete adherence. Virologic failure was identified in 48 (32%) of 150 subjects and was associated with incomplete adherence (AOR, 3.6; P=.03) and the proportion of months receiving self-funded antiretroviral therapy (AOR, 13.0; P=.02). Disclosure of HIV infection status to family members or others was protective against virologic failure (AOR, 0.10; P=.04). CONCLUSIONS: Self-funded treatment was associated with incomplete adherence and virologic failure, and disclosure of HIV infection status was protective against virologic failure. Efforts to provide free antiretroviral therapy and to promote social coping may enhance adherence and reduce rates of virologic failure.
BACKGROUND: Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance is essential to achieving long-term success. METHODS: A total of 150 subjects who had received antiretroviral therapy for at least 6 months completed a structured questionnaire and adherence assessment, and plasma human immunodeficiency virus (HIV) RNA levels were measured. Virologic failure was defined as an HIV RNA level >400 copies/mL; for patients with an HIV RNA level >1000 copies/mL, genotypic antiviral drug resistance testing was performed. Predictors were analyzed using bivariable and multivariable logistic regression models. RESULTS: A total of 23 (16%) of 150 subjects reported incomplete adherence. Sacrificing health care for other necessities (adjusted odds ratio [AOR], 19.8; P<.01) and the proportion of months receiving self-funded treatment (AOR, 23.5; P=.04) were associated with incomplete adherence. Virologic failure was identified in 48 (32%) of 150 subjects and was associated with incomplete adherence (AOR, 3.6; P=.03) and the proportion of months receiving self-funded antiretroviral therapy (AOR, 13.0; P=.02). Disclosure of HIV infection status to family members or others was protective against virologic failure (AOR, 0.10; P=.04). CONCLUSIONS: Self-funded treatment was associated with incomplete adherence and virologic failure, and disclosure of HIV infection status was protective against virologic failure. Efforts to provide free antiretroviral therapy and to promote social coping may enhance adherence and reduce rates of virologic failure.
Authors: Ziad El-Khatib; Anna Mia Ekstrom; Johanna Ledwaba; Lerato Mohapi; Fatima Laher; Alan Karstaedt; Salome Charalambous; Max Petzold; David Katzenstein; Lynn Morris Journal: AIDS Date: 2010-07-17 Impact factor: 4.177
Authors: Sanjay Pujari; Preeyaporn Srasuebkul; Somnuek Sungkanuparph; Poh Lian Lim; Nagalingeswaran Kumarasamy; John Chuah; Ritesh N Kumar; Yi-Ming A Chen; Shinichi Oka; Jun Yong Choi; Man-Po Lee; Praphan Phanuphak; Adeeba Kamarulzaman; Christopher Lee; Zhang Fujie; Rosanna Ditangco; Vonthanak Saphonn; Thira Sirisanthana; Tuti Parwati Merati; Jeff Smith; Matthew G Law Journal: J Antivir Antiretrovir Date: 2009-11-01
Authors: Veronica Escamilla; Carla J Chibwesha; Matthew Gartland; Namwinga Chintu; Mwangelwa Mubiana-Mbewe; Kebby Musokotwane; Patrick Musonda; William C Miller; Jeffrey S A Stringer; Benjamin H Chi Journal: J Acquir Immune Defic Syndr Date: 2015-11-01 Impact factor: 3.731
Authors: Mark J Siedner; Alexander Lankowski; Alexander C Tsai; Conrad Muzoora; Jeffrey N Martin; Peter W Hunt; Jessica E Haberer; David R Bangsberg Journal: AIDS Date: 2013-06-01 Impact factor: 4.177
Authors: Eran Bendavid; Robin Wood; David A Katzenstein; Ahmed M Bayoumi; Douglas K Owens Journal: J Acquir Immune Defic Syndr Date: 2009-09-01 Impact factor: 3.731