The impact of specific HIV treatment-related adverse events on adherence to antiretroviral therapy: a systematic review and meta-analysis.
The impact of specific HIV treatment-related adverse events on adherence to antiretroviral therapy: a systematic review and meta-analysis.
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DOI：
10.1080/09540121.2012.712667
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发表时间：
2013
期刊：
影响因子：
1.7
通讯作者：
Maiese EM
中科院分区：
文献类型：
--
作者：
Al-Dakkak I;Patel S;McCann E;Gadkari A;Prajapati G;Maiese EM
人类免疫缺陷病毒(HIV)感染患者对抗逆转录病毒疗法(ARTS)的依从性不佳会增加病毒抑制不完全、病毒耐药性产生、进展为获得性免疫缺陷综合征和死亡的风险。这项研究评估了特定的治疗相关不良事件(AEs)对成年HIV患者人群中坚持抗逆转录病毒治疗的影响。通过搜索≥®和MEDLINE®数据库，对年龄为16岁的成年艾滋病毒感染患者的研究进行了系统的回顾，这些研究报告了影响接受抗逆转录病毒治疗的因素的优势比(OR)。数据库搜索与审查论文书目中的标题搜索相辅相成。在仅限于特定人口特征或行为风险的人群中进行的研究被排除在外。为了有资格纳入荟萃分析，与治疗相关的不良反应必须在所有研究中以类似的方式定义。此外，同一研究的多个OR被包括在不同研究亚组的情况下。随机效应模型用于合并OR值。总体而言，19项研究和18项与艺术相关的AE被纳入Meta分析。非特异性脑血栓栓塞组患者对抗逆转录病毒治疗的依从性显著低于未发生脑血栓栓塞组患者[OR=0.623；95%可信区间：0.465-0.834]。与不存在这些不良反应的患者相比，有疲劳(OR=0.631；95%CI：0.433~0.918)、困惑(OR=0.349；95%CI：0.184~0.661)、味觉障碍(OR=0.485；95%CI：0.303~0.775)和恶心(OR=0.574；95%CI：0.427~0.772)等特殊不良反应的患者接受抗逆转录病毒治疗的可能性显著降低。了解特定的与治疗相关的不良反应可能允许有针对性地处理这些事件，并仔细考虑耐受性良好的治疗方案，以改善ART的依从性和临床结果。
Poor adherence to antiretroviral therapies (ARTs) in human immunodeficiency virus (HIV)-infected patients increases the risk of incomplete viral suppression, development of viral resistance, progression to acquired immune deficiency syndrome and death. This study assesses the impact of specific treatment-related adverse events (AEs) on adherence to ART in the adult HIV patient population. A systematic review of studies involving adult HIV-infected patients aged ≥ 16 years that reported an odds ratio (OR) for factors affecting adherence to ART was conducted through a search of the EMBASE® and Medline® databases. Database searches were complemented with a search of titles in the bibliographies of review papers. Studies conducted in populations limited to a particular demographic characteristic or behavioural risk were excluded. To qualify for inclusion into a meta-analysis, treatment-related AEs had to be defined similarly across studies. Also, multiple ORs from the same study were included where study sub-groups were distinct. Random effects models were used to pool ORs. In total, 19 studies and 18 ART-related AEs were included in meta-analyses. Adherence to ART was significantly lower in patients with non-specific AEs than in patients who did not experience AEs [OR = 0.623; 95% confidence interval (CI): 0.465–0.834]. Patients with specific AEs such as fatigue (OR = 0.631; 95% CI: 0.433–0.918), confusion (OR = 0.349; 95% CI: 0.184–0.661), taste disturbances (OR = 0.485; 95% CI: 0.303–0.775) and nausea (OR = 0.574; 95% CI: 0.427–0.772) were significantly less likely to adhere to ART compared to patients without these AEs. Knowledge of specific treatment-related AEs may allow for targeted management of these events and a careful consideration of well-tolerated treatment regimens to improve ART adherence and clinical outcomes.
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影响因子：
15.8
作者：
Mills EJ;Nachega JB;Bangsberg DR;Singh S;Rachlis B;Wu P;Wilson K;Buchan I;Gill CJ;Cooper C
通讯作者：
Cooper C
DOI：
10.1097/00042560-200205010-00014
发表时间：
2002-05-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
de Olalla, PG;Knobel, H;Caylà, JA
通讯作者：
Caylà, JA
影响因子：
3.8
作者：
Bangsberg, DR;Perry, S;Moss, A
通讯作者：
Moss, A
DOI：
10.1097/00042560-200112150-00006
发表时间：
2001-12-15
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Ammassari, A;Murri, R;Antinori, A
通讯作者：
Antinori, A
影响因子：
11.8
作者：
Sethi, AK;Celentano, DD;Gallant, JE
通讯作者：
Gallant, JE