Antiretroviral medication adherence among the REACH HIV-infected adolescent cohort in the USA
Antiretroviral medication adherence among the REACH HIV-infected adolescent cohort in the USA
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DOI：
10.1080/09540120020018161
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发表时间：
2001-02-01
影响因子：
1.7
通讯作者：
Belzer, M
中科院分区：
文献类型：
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作者：
Murphy, DA;Wilson, CM;Belzer, M
在从美国13个城市招募的HIV感染青少年中调查了对高效抗逆转录病毒治疗（HAART）的依从性，这些青少年参加了REACH（达到卓越的青少年护理和健康）项目，这是第一个对通过性行为或注射毒品感染的HIV阳性青少年进行的大规模疾病进展研究。在161名受试者中，7%的人无法正确识别所有处方药; 11%的人可以识别，但从未服用过至少一种药物。大多数受试者（83%）报告至少部分时间服用了所有药物，但只有50%的受试者报告完全依从。因此，只有41%的样本报告完全遵守。一个很强的关联被发现之间的遵守和减少病毒载量。CD 4水平大于或等于500个细胞/mm（3）也与粘附相关。较高水平的抑郁症与依从性降低显著相关，并且发现处方药物数量与依从性之间存在相关性。严格遵守HAART对于持续抑制病毒复制、允许免疫恢复和降低选择性抗病毒药物耐药性的风险至关重要。坚持似乎是一个严重的问题，艾滋病毒阳性的青少年。更好的教育，干预以缓解抑郁症，并努力提高药物使用的便利性是必不可少的。
Adherence to highly active antiretroviral therapy (HAART) was investigated among HIV-infected adolescents recruited from 13 US cities into the REACH (Reaching for Excellence in Adolescent Care and Health) project, the first large-scale disease progression study of HIV-positive adolescents infected through sexual behaviour or injection drug use. Of 161 subjects, 7% could not correctly identify all their prescribed medications; 11% could identify them but reported never taking at least one medication. The majority (83%) reported taking all of their medications at least some of the rime, but only 50% of these subjects reported full adherence. Therefore, only 41% of the sample reported full adherence. A strong association was found between adherence and reduced viral load. A CD4 level of greater than or equal to 500 cells/mm(3) was also associated with adherence. Higher levels of depression were significantly associated with decreased adherence, and a trend was found for an association between number of medications prescribed and adherence. Strict adherence to HAART is critical for sustained suppression of viral replication allowing for immune recovery and reducing the risk of the selection of antiviral resistance. Adherence appears to be a serious problem among HIV-positive adolescents. Better education, intervention to relieve depression, and efforts to improve ease of medication use are essential.