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Long-term trends in adherence to antiretroviral therapy from start of HAART.
AIDS. 2010 May 15; 24(8):1153-62.AIDS

Abstract

OBJECTIVE

People on antiretroviral therapy are likely to be required to maintain good adherence throughout their lives. We aimed to investigate long-term trends in highly active antiretroviral therapy (HAART) adherence to identify the main predictors and to evaluate whether participants experience periods of low adherence (<or=60%).

METHODS

Participants in the Royal Free Clinic Cohort were followed from the date of start of HAART until the end of the last recorded ART prescription or death. Follow-up was divided into 6-month periods, and for each period, a value of adherence, measured as the percentage of days in the 6-month period covered by a valid prescription for at least three antiretroviral drugs, was calculated.

RESULTS

Patients were assessed for drug coverage adherence for a median of 4.5 years [inter-quartile range (IQR) 2.4-7.2; maximum 9 years] covering a period up to 13 years from start of HAART. There was evidence of a slight increase in adherence over time [adjusted odds ratio (OR) of >95% adherence = 1.02 per year; 95% confidence interval (CI) 1.01-1.04; P = 0.0053]. Independent predictors of adherence were age, demographic group, calendar year period, drug regimen and previous virologic failures. The overall rate of at least one period of low adherence was 0.12 per person-year, but this rate decrease markedly over time to 0.01 in 2007/2008.

CONCLUSION

Adherence, as measured by drug coverage, does not decrease on average over more than a decade from start of HAART. This is encouraging, because it shows that patients could potentially maintain viral suppression for many years.

Authors+Show Affiliations

HIV Epidemiology & Biostatistics Group, Research Department of Infection & Population Health, UCL Medical School, Royal Free Campus, London, UK. v.cambiano@ucl.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20299959

Citation

Cambiano, Valentina, et al. "Long-term Trends in Adherence to Antiretroviral Therapy From Start of HAART." AIDS (London, England), vol. 24, no. 8, 2010, pp. 1153-62.
Cambiano V, Lampe FC, Rodger AJ, et al. Long-term trends in adherence to antiretroviral therapy from start of HAART. AIDS. 2010;24(8):1153-62.
Cambiano, V., Lampe, F. C., Rodger, A. J., Smith, C. J., Geretti, A. M., Lodwick, R. K., Puradiredja, D. I., Johnson, M., Swaden, L., & Phillips, A. N. (2010). Long-term trends in adherence to antiretroviral therapy from start of HAART. AIDS (London, England), 24(8), 1153-62. https://doi.org/10.1097/QAD.0b013e32833847af
Cambiano V, et al. Long-term Trends in Adherence to Antiretroviral Therapy From Start of HAART. AIDS. 2010 May 15;24(8):1153-62. PubMed PMID: 20299959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term trends in adherence to antiretroviral therapy from start of HAART. AU - Cambiano,Valentina, AU - Lampe,Fiona C, AU - Rodger,Alison J, AU - Smith,Colette J, AU - Geretti,Anna M, AU - Lodwick,Rebecca K, AU - Puradiredja,Dewi I, AU - Johnson,Margaret, AU - Swaden,Leonie, AU - Phillips,Andrew N, PY - 2010/3/20/entrez PY - 2010/3/20/pubmed PY - 2011/4/1/medline SP - 1153 EP - 62 JF - AIDS (London, England) JO - AIDS VL - 24 IS - 8 N2 - OBJECTIVE: People on antiretroviral therapy are likely to be required to maintain good adherence throughout their lives. We aimed to investigate long-term trends in highly active antiretroviral therapy (HAART) adherence to identify the main predictors and to evaluate whether participants experience periods of low adherence (<or=60%). METHODS: Participants in the Royal Free Clinic Cohort were followed from the date of start of HAART until the end of the last recorded ART prescription or death. Follow-up was divided into 6-month periods, and for each period, a value of adherence, measured as the percentage of days in the 6-month period covered by a valid prescription for at least three antiretroviral drugs, was calculated. RESULTS: Patients were assessed for drug coverage adherence for a median of 4.5 years [inter-quartile range (IQR) 2.4-7.2; maximum 9 years] covering a period up to 13 years from start of HAART. There was evidence of a slight increase in adherence over time [adjusted odds ratio (OR) of >95% adherence = 1.02 per year; 95% confidence interval (CI) 1.01-1.04; P = 0.0053]. Independent predictors of adherence were age, demographic group, calendar year period, drug regimen and previous virologic failures. The overall rate of at least one period of low adherence was 0.12 per person-year, but this rate decrease markedly over time to 0.01 in 2007/2008. CONCLUSION: Adherence, as measured by drug coverage, does not decrease on average over more than a decade from start of HAART. This is encouraging, because it shows that patients could potentially maintain viral suppression for many years. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/20299959/Long_term_trends_in_adherence_to_antiretroviral_therapy_from_start_of_HAART_ L2 - http://Insights.ovid.com/pubmed?pmid=20299959 DB - PRIME DP - Unbound Medicine ER -