Aging, antiretrovirals, and adherence: a meta analysis of adherence among older HIV-infected individuals.
Aging, antiretrovirals, and adherence: a meta analysis of adherence among older HIV-infected individuals.
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DOI：
10.1007/s40266-013-0107-7
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发表时间：
2013-10
期刊：
影响因子：
2.8
通讯作者：
Rudolph, James L.
中科院分区：
文献类型：
--
作者：
Ghidei, Luwam;Simone, Mark J.;Salow, Marci J.;Zimmerman, Kristin M.;Paquin, Allison M.;Skarf, Lara M.;Kostas, Tia R. M.;Rudolph, James L.
由于药物复杂性、副作用、费用和认知能力下降等因素，老年人通常被认为有更大的药物依从性风险。然而，这种概括可能不适用于感染人类免疫缺陷病毒（HIV）的老年人。无论年龄大小，抗逆转录病毒治疗（ART）的依从性不佳可导致病毒载量增加、免疫抑制、耐药病毒株、合并症和机会性感染。了解老年人坚持抗逆转录病毒治疗的趋势至关重要，特别是随着艾滋病毒感染者年龄的增长。本系统综述和荟萃分析的目的是确定老年艾滋病毒感染者是否比年轻艾滋病毒感染者更不可能不坚持抗逆转录病毒治疗。在PubMed， Embase和PsycINFO中进行了系统搜索，以确定同行评审的评估老年人抗逆转录病毒治疗依从性的文章。两名独立审稿人筛选摘要，应用纳入标准，并评价研究质量。检索符合条件的研究的参考书目。数据来自两位独立作者的研究。进行了荟萃分析，并报告了老年人与年轻人相比的依从性水平的相对风险。系统搜索产生了1,848篇摘要。12项研究完全符合纳入标准。总体荟萃分析发现，年龄越大，不依从性风险降低27%（相对风险（RR） 0.72, 95%置信区间（CI） 0.64-0.82）。评估短期和长期依从性的研究表明，老年患者的不依从性显著降低（RR分别为0.75,95% CI 0.64-0.87和RR 0.65, 95% CI 0.50-0.85）。携带艾滋病毒的老年人不坚持抗逆转录病毒治疗的风险比年轻人低。未来的研究应寻求阐明老年艾滋病毒感染者依从性的影响因素。
Older adults are generally considered to be at greater risk for medication non-adherence due to factors such as medication complexity, side effects, cost, and cognitive decline. However, this generalization may not apply to older adults with human immunodeficiency virus (HIV). Regardless of age, suboptimal adherence to antiretroviral therapy (ART) can lead to increased viral load, immunosuppression, drug-resistant viral strains, co-morbidities, and opportunistic infections. Understanding trends of adherence to ART among older adults is critical, especially as the population of people living with HIV grows older. The purpose of this systematic review and meta-analysis is to determine if older individuals with HIV are less likely to be non-adherent to antiretroviral therapy than younger individuals with HIV. A systematic search in PubMed, Embase, and PsycINFO was conducted to identify peer-reviewed articles evaluating adherence to ART in older adults. Two independent reviewers screened abstracts, applied inclusion criteria, and appraised study quality. The bibliographies of qualifying studies were searched. Data were abstracted from studies by two independent authors. Meta-analyses were conducted, and adherence levels were reported as the relative risk of non-adherence in older individuals compared to younger individuals. The systematic search yielded 1,848 abstracts. Twelve studies met full inclusion criteria. The overall meta-analysis found that older age reduced risk for non-adherence by 27% (Relative Risk (RR) 0.72, 95% Confidence Interval (CI) 0.64–0.82). Studies assessing both short-term and long-term adherence demonstrated a significant reduction in non-adherence among older patients (RR 0.75, 95% CI 0.64–0.87 and RR 0.65, 95% CI 0.50–0.85, respectively). Older adults with HIV have a reduced risk for non-adherence to ART than their younger counterparts. Future studies should seek to elucidate contributing factors of adherence among older individuals with HIV.
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DOI：
10.1016/s0140-6736(08)61113-7
发表时间：
2008-07-26
期刊：
Lancet (London, England)
影响因子：
--
作者：
Antiretroviral Therapy Cohort Collaboration
通讯作者：
Antiretroviral Therapy Cohort Collaboration
DOI：
10.1097/01.qai.0000248354.63748.54
发表时间：
2007-01-01
影响因子：
3.6
作者：
Holodniy, Mark;Hornberger, John;Deyton, Lawrence
通讯作者：
Deyton, Lawrence
影响因子：
4.6
作者：
Justice, Amy C
通讯作者：
Justice, Amy C
DOI：
10.1080/09540121.2010.525603
发表时间：
2011-01-01
影响因子：
1.7
作者：
Kyser, Melanie;Buchacz, Kate;Brooks, John T.
通讯作者：
Brooks, John T.
DOI：
10.1097/00126334-200101010-00012
发表时间：
2001-01-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Kleeberger, CA;Phair, JP;Jacobson, LP
通讯作者：
Jacobson, LP