Factors associated with non-adherence to antiretroviral therapy in the SUN study
Factors associated with non-adherence to antiretroviral therapy in the SUN study
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DOI：
10.1080/09540121.2010.525603
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发表时间：
2011-01-01
影响因子：
1.7
通讯作者：
Brooks, John T.
中科院分区：
文献类型：
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作者：
Kyser, Melanie;Buchacz, Kate;Brooks, John T.
背景资料。通常认为，要在HIV感染患者中实现最佳病毒学抑制，必须坚持95%或更高的高效联合抗逆转录病毒治疗。了解与依从性差相关的因素对于改善患者依从性、最大限度地抑制病毒学、降低发病率和死亡率至关重要。在一项多中心的纵向前瞻性队列研究(SUN研究)中，我们评估了从2004年3月至2006年6月登记的528名服用抗逆转录病毒药物的患者的基线数据。我们使用多元Logistic回归分析了不遵守的独立危险因素，定义为在基线调查问卷上报告在过去三天内错过了一剂或多剂抗逆转录病毒药物。在528名参与者(女性22%，黑人28%，年龄中位数41岁，CD4细胞计数中位数486个/mm(3))中，85人(16%)未黏附。在最终的简约多变量模型中，与不遵守的独立相关的因素包括黑人种族(调整后的优势比(AOR)：2.08，95%可信区间(CI)：1.20-3.60对白人)，失业和找工作(AOR：2.03，95%CI：1.14-3.61对所有其他职业类别)，5年前被诊断出感染艾滋病毒(AOR：1.95，95%CI：1.18-3.24对被诊断为HIV
Background. Adherence of 95% or greater to highly active combination antiretroviral therapy is generally considered necessary to achieve optimal virologic suppression in HIV-infected patients. Understanding factors associated with poor adherence is essential to improve patient compliance, maximize virologic suppression, and reduce morbidity and mortality.Methods. We evaluated baseline data from 528 patients taking antiretrovirals, enrolled from March 2004 to June 2006, in a multicenter, longitudinal, prospective cohort study (the SUN study). Using multiple logistic regression, we examined independent risk factors for non-adherence, defined as reporting having missed one or more antiretroviral doses in the past three days on the baseline questionnaire.Results. Of 528 participants (22% female, 28% black, median age 41 years, and median CD4 cell count 486 cells/mm(3)), 85 (16%) were non-adherent. In the final parsimonious multivariate model, factors independently associated with non-adherence included black race (adjusted odds ratio (aOR): 2.08, 95% confidence interval (CI): 1.20-3.60 vs. white race), being unemployed and looking for work (aOR: 2.03, 95% CI: 1.14-3.61 vs. all other employment categories), having been diagnosed with HIV >= 5 years ago (aOR: 1.95, 95% CI: 1.18-3.24 vs. being HIV-diagnosed