Article Text

PDF
CP-023 Effect of treatment complexity on medicines adherence and incidence of blips in HIV/HCV co-infected patients
  1. E Calvo-Cidoncha1,
  2. J González-Bueno2,
  3. MA Robustillo-Cortés1,
  4. S Santana-Martínez3,
  5. Y Borrego-Izquierdo1,
  6. R Jiménez-Galán1,
  7. P Monje-Agudo1,
  8. E Gómez-Fernández1,
  9. R Cantudo-Cuenca1,
  10. R Morillo-Verdugo1
  1. 1Hospital Universitario de Valme, Pharmacy, Seville, Spain
  2. 2Hospital Universitario Virgen del Rocío, Pharmacy, Seville, Spain
  3. 3Hospital Virgen Macarena, Pharmacy, Seville, Spain

Abstract

Background Anti-HCV treatment may add significant complexity to antiretroviral treatment (ART). The complexity of the medicines regimen could be a risk factor for non-adherence or increasing incidence of blips.

Purpose To determine if the addition of anti-HCV treatment to antiretroviral treatment increases the complexity of the treatment, therefore modifying medicines adherence and incidence of blips.

Materials and methods We conducted a retrospective observational study. HIV/HCV co-infected patients treated with interferon alfa-2a plus ribavirin for at least 12 weeks between 01/2008–06/2012 were included. We excluded patients with HIV viral load >50 copies RNA/mL in the six months prior to the introduction of anti-HCV treatment. The following variables were collected: sex, age, weeks on anti-HCV treatment and incidence of blips. Additionally, adherence (≥95%) and complexity index were collected before and after the addition of anti-HCV treatment. Blips were defined as a detectable HIV-RNA level (>50 copies/mL but no more than 1000 copies/mL) occurring between 2 negative assays. Complexity index was calculated based on a score (Martin et al , 2007) which considers number of pills taken per day, dosing schedule, dosage form and any specific instructions related to drug use. Quantitative and dichotomous variables were compared using the t-test for related samples and McNemar’s test respectively (confidence interval (CI) 95%). Data analysis was carried out using SPSS 20.0.

Results 36 patients were included (75% male, mean age 47 ± 5). The mean duration on anti-HCV treatment was 41 ± 18 weeks. The mean value of the complexity index before and after the addition of anti-HCV treatment to ART was 5.3 ± 1.9 and 11.4 ± 1.6 respectively (p < 0.001, CI:-6,68;-5,56). 4 out of 36 (11.1%) patients experienced viral blips (p > 0.005). After the introduction of the anti-HCV treatment, the number of non-adherent patients showed a non-significant increase from 11% to 22%.

Conclusions The addition of anti-HCV treatment to ART correlates with a significant increase in the complexity index, leading to higher non-adherence and blips rates.

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.