Clinical Utility of Pharmacy-Based Adherence Measurement in Predicting Virologic Outcomes in an Adult HIV-Infected Cohort in Jos, North Central Nigeria.
Clinical Utility of Pharmacy-Based Adherence Measurement in Predicting Virologic Outcomes in an Adult HIV-Infected Cohort in Jos, North Central Nigeria.
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DOI：
10.1177/2325957414539197
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发表时间：
2016-01-01
影响因子：
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通讯作者：
Okonkwo, Prosper
中科院分区：
文献类型：
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作者：
Abah, Isaac Okoh;Ojeh, Victor Bazim;Okonkwo, Prosper
目的：我们研究了在尼日利亚中北部接受联合抗逆转录病毒治疗（cART）的艾滋病毒感染成年人队列中，坚持药物补充访视与病毒学结局之间的相关性。方法：对2009年至2010年在乔斯大学教学医院接受一线抗逆转录病毒治疗的588例艾滋病毒感染、cART初治成年人（年龄≥15岁）进行了回顾性评价。使用多变量logistic regression.Results评估了坚持药物再填充访视、病毒学（病毒载量>1000拷贝/mL）和免疫学失败之间的关联：在接受cART中位数12个月后，分别有16%（n=94）和10%（n=59）的患者出现病毒学和免疫学失败。在最后的多变量模型中，药物再填充访视的次优依从性是病毒学（调整后的比值比[AOR] 1.6; 95%置信区间[CI]：1.2-2.3）和免疫学（AOR 1.92; 95% CI：1.06-3.49）失败的重要预测因子。结论：药物再填充依从性是成功病毒学控制的有用预测因子，可用于我们临床环境中cART依从性的常规监测。
OBJECTIVES: We examined the association between adherence to drug-refill visits and virologic outcomes in a cohort of HIV-infected adults on combination antiretroviral therapy (cART) in North Central Nigeria.METHODS: Retrospectively, 588 HIV-infected, cART-naive adults (aged ≥15 years), initiated on first-line ART between 2009 and 2010 at the Jos University Teaching Hospital, were evaluated. Association between adherence to drug-refill visits, virologic (viral load>1000 copies/mL), and immunologic failure was assessed using multivariable logistic regression.RESULTS: After a median of 12 months on cART, 16% (n=94) and 10% (n=59) of patients had virologic and immunologic failures, respectively. In the final multivariable model, suboptimal adherence to drug-refill visits was a significant predictor of both virologic (adjusted odds ratio [AOR] 1.6; 95% confidence interval [CI]:1.2-2.3) and immunologic (AOR 1.92; 95% CI:1.06-3.49) failures.CONCLUSION: Adherence to drug refill is a useful predictor of successful virologic control and could be utilized for routine monitoring of adherence to cART in our clinical setting.