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Titolo:
Determinants of heterogeneous adherence to HIV-antiretroviral therapies inthe multicenter AIDS cohort study
Autore:
Kleeberger, CA; Phair, JP; Strathdee, SA; Detels, R; Kingsley, L; Jacobson, LP;
Indirizzi:
Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA Johns Hopkins Univ Baltimore MD USA 21205 demiol, Baltimore, MD 21205 USA Northwestern Univ, Sch Med, Comprehens AIDS Ctr, Chicago, IL 60611 USA Northwestern Univ Chicago IL USA 60611 ns AIDS Ctr, Chicago, IL 60611 USA Univ Calif Los Angeles, Sch Publ Hlth, Dept Epidemiol, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA Univ Pittsburgh, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USAUniv Pittsburgh, Pittsburgh, PA USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 1, volume: 26, anno: 2001,
pagine: 82 - 92
SICI:
1525-4135(20010101)26:1<82:DOHATH>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; INFECTED PATIENTS; ZIDOVUDINE; INDIVIDUALS; TUSKEGEE; PANEL; TRIAL;
Keywords:
medication adherence; antiretroviral therapy; HIV-1; cohort studies;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
45
Recensione:
Indirizzi per estratti:
Indirizzo: Kleeberger, CA Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Room E7003, Baltimore, MD 21205 USA Johns Hopkins Univ Room E7003 Baltimore MD USA 21205 05 USA
Citazione:
C.A. Kleeberger et al., "Determinants of heterogeneous adherence to HIV-antiretroviral therapies inthe multicenter AIDS cohort study", J ACQ IMM D, 26(1), 2001, pp. 82-92

Abstract

Assessment of adherence to HIV antiretroviral therapy (ART) is required for studying therapeutic effectiveness and identifying subgroups needing focused education. The study's goals were to describe the level of ART adherence using self-reported recall over a it-day period and to characterize determinants of lower adherence. The interaction between adherence and drug holidays on level of HIV RNA also was investigated. Perfect self-reported adherence was defined as taking all doses and numbers of pills as prescribed forcurrent HIV medications. Independent predictors of <100% adherence were determined using multivariate logistic regression. Among 539 men, 419 (77.7%)were 100% adherent by the algorithm using self-reported data. HIV-1 RNA was <50 copies/ml in 48.2% of the adherent group versus 33.7% in the less adherent group (p = .015). This proportion dropped to 28% if a drug holiday was reported in addition to lower adherence. A drug holiday was not virologically detrimental if the participant was otherwise adherent. Determinants oflower adherence included African American race (odds ratio [OR], 2.4; p = .008), income <U.S.$50.000 (OR, 2.2; p = .002), no outpatient visits (OR, 3.6; p = .003) and increasing numbers of ART medications (OR, 4.5; p = .001). These data support the validity of using a questionnaire to assess adherence in observational studies. Identification of individuals with characteristics associated with lower adherence provides the basis for interventions to enhance adherence and optimize effective therapies.

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Documento generato il 09/04/20 alle ore 20:12:13