Adherence to antiretrovirals among US women during and after pregnancy.
Adherence to antiretrovirals among US women during and after pregnancy.
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DOI：
10.1097/qai.0b013e31817bbe80
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发表时间：
2008-08-01
期刊：
影响因子：
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通讯作者：
PACTG 1025 Protocol Team
中科院分区：
文献类型：
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作者：
Bardeguez AD;Lindsey JC;Shannon M;Tuomala RE;Cohn SE;Smith E;Stek A;Buschur S;Cotter A;Bettica L;Read JS;PACTG 1025 Protocol Team
抗逆转录病毒药物(ARV)被推荐用于孕产妇健康和减少HIV-1母婴传播，但不理想的坚持可能抵消其好处。描述产前和产后对抗逆转录病毒治疗方案的依从性以及与依从性相关的因素。我们在2002年8月至2005年7月期间，通过至少一次自我报告依从性评估，评估了参加1025儿科艾滋病临床试验小组方案的受试者对片剂制剂的依从率。完全遵守的受试者在研究访问前4天没有报告遗漏剂量。广义估计方程用于比较产前和产后依从率，并确定与完美依从性相关的因素。在519名符合条件的受试者中，334/445人(75%)报告在怀孕期间完全遵守。产后6周、24周和48周这一比例显著降低[分别为185/284(65%)、76/118(%)和42/(66%)(P<；0.01)]。完全依从性的受试者病毒载量较低。那些在怀孕期间开始服用抗逆转录病毒药物(P<；0.01)、没有艾滋病(P=0.02)、从未错过产前维生素(P<；0.01)、从未使用过大麻(P=0.05)、或在所有或大部分时间感到快乐(P<；0.01)的女性，完全坚持的几率显著更高(P<；0.01)。产前对抗逆转录病毒药物的完全依从性更好，但总体比率较低。需要采取干预措施，提高怀孕期间的依从性。
Antiretrovirals (ARVs) are recommended for maternal health and to reduce HIV-1 mother-to-child transmission, but suboptimal adherence can counteract its benefits. To describe antepartum and postpartum adherence to ARV regimens and factors associated with adherence. We assessed adherence rates among subjects enrolled in Pediatric AIDS Clinical Trials Group Protocol 1025 from August 2002 to July 2005 on tablet formulations with at least one self-report adherence assessment. Perfectly adherent subjects reported no missed doses 4 days before their study visit. Generalized estimating equations were used to compare antepartum with postpartum adherence rates and to identify factors associated with perfect adherence. Of 519 eligible subjects, 334/445 (75%) reported perfect adherence during pregnancy. This rate significantly decreased 6, 24, and 48 weeks postpartum [185/284 (65%), 76/118 (64%), and 42/64 (66%), respectively (P < 0.01)]. Pregnant subjects with perfect adherence had lower viral loads. The odds of perfect adherence were significantly higher for women who initiated ARVs during pregnancy (P < 0.01), did not have AIDS (P = 0.02), never missed prenatal vitamins (P < 0.01), never used marijuana (P = 0.05), or felt happy all or most of the time (P < 0.01). Perfect adherence to ARVs was better antepartum, but overall rates were low. Interventions to improve adherence during pregnancy are needed.