Adherence to antiretroviral therapy in patients enrolled in a comprehensive care program in Cambodia: a 24-month follow-up assessment

Hdl Handle:
http://hdl.handle.net/10144/116996
Title:
Adherence to antiretroviral therapy in patients enrolled in a comprehensive care program in Cambodia: a 24-month follow-up assessment
Authors:
Spire, Bruno; Carrieri, Patrizia; Sopha, Pal; Protopopescu, Camelia; Prak, Narom; Quillet, Catherine; Ngeth, Chanchhaya; Ferradini, Laurent; Delfraissy, Jean-François; Laureillard, Didier
Journal:
Antiviral Therapy
Abstract:
BACKGROUND: The long-term maintenance of antiretroviral therapy (ART) remains an important issue, especially in limited-resource settings where additional barriers exist. A cross-sectional study was performed 24 months after ART initiation for patients treated in Cambodia in order to estimate the prevalence and identify determinants of non-adherence. METHODS: Adults receiving ART for 24 +/- 2 months were considered eligible for the study. Self-reported non-adherence was defined according to an algorithm based on six items. The questionnaire also assessed ART-related side effects and HIV disclosure. HIV-1 RNA plasma viral load was measured using real-time PCR. Multivariate rare events logistic regression analysis was used to identify independent factors associated with non-adherence. RESULTS: A total of 346 patients participated in the study. At 24 months, 95% of patients were adherent, 80% had HIV RNA <40 copies/ml and 75% had CD4+ T-cell counts >200 cells/mm3. Virological success was significantly higher in adherent patients than in non-adherent patients (81% versus 56%, P=0.021). Living in a rural area, limited HIV disclosure and perceived lipodystrophy were independently associated with non-adherence. CONCLUSIONS: At 24 months, adherence to ART was high and explained positive virological outcomes. In order to maintain adherence and long-term virological benefits, special attention should be given to patients living in rural areas, those with lipodystrophy-related symptoms and others who express difficulties disclosing their condition to close family members.
Affiliation:
Inserm U912, Economic and Social Sciences, Health Systems and Societies, Marseille, France; Infectious Disease Department, Khmero-Sovietic Friendship Hospital, Phnom Penh, Cambodia; Médecins Sans Frontières, Paris, France; Epicentre, Paris, France; Clinical Immunology Department, Bicêtre Hospital, Kremlin Bicêtre, France; Immunological Department, Georges Pompidou, European Hospital, Paris France
Issue Date:
May-2008
URI:
http://hdl.handle.net/10144/116996
PubMed ID:
18771053
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed
Submitted date:
2008-05-06
Language:
en
ISSN:
1359-6535
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorSpire, Brunoen
dc.contributor.authorCarrieri, Patriziaen
dc.contributor.authorSopha, Palen
dc.contributor.authorProtopopescu, Cameliaen
dc.contributor.authorPrak, Naromen
dc.contributor.authorQuillet, Catherineen
dc.contributor.authorNgeth, Chanchhayaen
dc.contributor.authorFerradini, Laurenten
dc.contributor.authorDelfraissy, Jean-Françoisen
dc.contributor.authorLaureillard, Didieren
dc.date.accessioned2010-12-02T19:25:47Z-
dc.date.available2010-12-02T19:25:47Z-
dc.date.issued2008-05-
dc.date.submitted2008-05-06-
dc.identifier.citationAntivir. Ther. (Lond.) 2008;13(5):697-703en
dc.identifier.issn1359-6535-
dc.identifier.pmid18771053-
dc.identifier.urihttp://hdl.handle.net/10144/116996-
dc.description.abstractBACKGROUND: The long-term maintenance of antiretroviral therapy (ART) remains an important issue, especially in limited-resource settings where additional barriers exist. A cross-sectional study was performed 24 months after ART initiation for patients treated in Cambodia in order to estimate the prevalence and identify determinants of non-adherence. METHODS: Adults receiving ART for 24 +/- 2 months were considered eligible for the study. Self-reported non-adherence was defined according to an algorithm based on six items. The questionnaire also assessed ART-related side effects and HIV disclosure. HIV-1 RNA plasma viral load was measured using real-time PCR. Multivariate rare events logistic regression analysis was used to identify independent factors associated with non-adherence. RESULTS: A total of 346 patients participated in the study. At 24 months, 95% of patients were adherent, 80% had HIV RNA <40 copies/ml and 75% had CD4+ T-cell counts >200 cells/mm3. Virological success was significantly higher in adherent patients than in non-adherent patients (81% versus 56%, P=0.021). Living in a rural area, limited HIV disclosure and perceived lipodystrophy were independently associated with non-adherence. CONCLUSIONS: At 24 months, adherence to ART was high and explained positive virological outcomes. In order to maintain adherence and long-term virological benefits, special attention should be given to patients living in rural areas, those with lipodystrophy-related symptoms and others who express difficulties disclosing their condition to close family members.en
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmeden
dc.rightsArchived on this site with kind permission of International Medical Press. http://www.intmedpress.comen
dc.subject.meshAdulten
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshCambodiaen
dc.subject.meshComprehensive Health Careen
dc.subject.meshCross-Sectional Studiesen
dc.subject.meshDrug Therapy, Combinationen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHIV-1en
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshPatient Complianceen
dc.subject.meshPrevalenceen
dc.subject.meshProgram Evaluationen
dc.subject.meshReverse Transcriptase Inhibitorsen
dc.subject.meshTreatment Outcomeen
dc.subject.meshViral Loaden
dc.titleAdherence to antiretroviral therapy in patients enrolled in a comprehensive care program in Cambodia: a 24-month follow-up assessmenten
dc.contributor.departmentInserm U912, Economic and Social Sciences, Health Systems and Societies, Marseille, France; Infectious Disease Department, Khmero-Sovietic Friendship Hospital, Phnom Penh, Cambodia; Médecins Sans Frontières, Paris, France; Epicentre, Paris, France; Clinical Immunology Department, Bicêtre Hospital, Kremlin Bicêtre, France; Immunological Department, Georges Pompidou, European Hospital, Paris Franceen
dc.identifier.journalAntiviral Therapyen

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