Background A lack of adherence to antiretroviral treatment (ART) is the main cause of treatment failure in both children and adults, and it is particularly important in adolescents.
Purpose To determine the adherence to ART in HIV-infected children.
Materials and methods A one-year observational study (January–December 2012) of HIV paediatric patients. Data collected: age, gender, HIV transmission mode, hepatitis C status, ART, adherence rate, HIV viral load, CD4 cell count, person who collects and administers ART. Adherence was measured by pharmacy refill records, as ‘total number units dispensed/total number units needed’ x 100. Patients were considered as: adherent (adherence rate ≥90%) or non adherent (adherence rate <90%)
Results 14 patients were analysed. Age range: 6–15 years: 10 patients; 18–20 years: 4 patients. 50% male; HIV transmission mode was vertical and 14% were co-infected with hepatitis C. ART received: boosted protease inhibitor (IP/r) with two nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) in 43% patients, IP/r with one NRTI in 14% patients, one non-nucleoside reverse transcriptase inhibitor (NNRTI) with two NRTIs 14% patients, IP/r with an integrase inhibitor in 22% patients and IP/r with one NNRTI in 7% patients. Patients from 6 to 15 years old were 80% adherent; however, the group from 18 to 20 years old was non-adherent. Adherent patients had HIV viral load <20 copies/mL and non-adherent patients had viral load >20 copies/mL, except in 2 patients. All patients had CD4 cell count over 500 cells/mm3. Parent patients or caregivers in the age 6–15 group were responsible for collecting and administering the ART, however, in the group from 18 to 20 years old it was the patient.
Conclusions Adherence in patients under the responsibility of family members or care-givers (6–15 years old) was 80%, and was related to the effectiveness of ART. When patients were in charge of their own treatment, adolescents were less compliant and virological failure was greater.
No conflict of interest.
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