Article Text

PDF

CPC-058 Factors Associated with Antiretroviral Medicines Adherence Among HIV-Infected Children
  1. C Casado,
  2. A Gil,
  3. ME Martínez,
  4. JM Ramón,
  5. L López,
  6. T Molina
  1. Hospital Universitario de Getafe, Pharmacy, Madrid, Spain

Abstract

Background The aims of highly active antiretroviral therapy (HAART) in HIV-infected children are to achieve and sustain full HIV-RNA viral load (VL) suppression and CD4-reconstitution, in order to prevent the progression of the HIV infection and allow normal growth and development.

Adherence to HAART is a strong predictor of therapeutic efficacy. Previous studies have shown that therapeutic success requires adherence > 95%. Among paediatric HIV patients, adherence to HAART is reportedly suboptimal.

There are a number of factors that can compromise treatment compliance. These can be classified as those related to the medicine, the patient, the family/caregiver and the healthcare system.

Purpose To estimate the correlation between adherence to HAART and treatment efficacy.

To assess factors related to non-adherence among HIV-infected children.

Materials and Methods Retrospective cohort study from January 2008 to July 2012 including all HIV-infected patients on HAART followed by the Paediatrics Department.

Age, sex, lipoatrophy, number of pills/day (P/d) and frequency of daily dosing: once a day (QD) or twice a day (BID), were analysed.

Adherence was assessed by using the pharmacy refill records and pill count, according to the following formula:

Adherence (%) = (Nº dispensed doses- Nº returned doses)/Nº prescribed doses × 100

Undetectable VL was defined as VL < 20 copies/ml.

Data were analysed by multiple logistic regression methods using SPSS software (version 19.0).

Results 24 HIV-infected patients were included (mean age = 15.3 ± 5.5 years; 29.2% male, 70.8% female).

37.5% of patients presented lipoatrophy.

54.2% and 45.8% of the children were treated with a QD and BID regimen, respectively.

Only 50% of patients were considered adherent to treatment (adherence >95%).

The relationship between risk factors and adherence was: see Table

Patients with poor adherence had a higher risk of virological failure (OR = 11.67; CI95 = 1.14–119.54;p = 0.039)

Conclusions Adherence to HAART represents a significant challenge in the paediatric HIV population.

The P/d was significantly associated with adherence. Every pill/day increased up to 2.3-fold the risk of non-adherence to HAART.

Simplifying HAART by reducing the pill burden may contribute to improving compliance in the paediatric HIV population.

View this table:
Abstract CPC-058 Table 1

No conflict of interest.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.