PMID- 20299959
OWN - NLM
STAT- MEDLINE
DCOM- 20110331
LR  - 20220318
IS  - 1473-5571 (Electronic)
IS  - 0269-9370 (Linking)
VI  - 24
IP  - 8
DP  - 2010 May 15
TI  - Long-term trends in adherence to antiretroviral therapy from start of HAART.
PG  - 1153-62
LID - 10.1097/QAD.0b013e32833847af [doi]
AB  - 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.
FAU - Cambiano, Valentina
AU  - Cambiano V
AD  - HIV Epidemiology & Biostatistics Group, Research Department of Infection & 
      Population Health, UCL Medical School, Royal Free Campus, London, UK. 
      v.cambiano@ucl.ac.uk
FAU - Lampe, Fiona C
AU  - Lampe FC
FAU - Rodger, Alison J
AU  - Rodger AJ
FAU - Smith, Colette J
AU  - Smith CJ
FAU - Geretti, Anna M
AU  - Geretti AM
FAU - Lodwick, Rebecca K
AU  - Lodwick RK
FAU - Puradiredja, Dewi I
AU  - Puradiredja DI
FAU - Johnson, Margaret
AU  - Johnson M
FAU - Swaden, Leonie
AU  - Swaden L
FAU - Phillips, Andrew N
AU  - Phillips AN
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
SB  - IM
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active
MH  - CD4 Lymphocyte Count
MH  - Female
MH  - HIV Infections/drug therapy/epidemiology/*psychology
MH  - *HIV-1
MH  - Humans
MH  - Male
MH  - Medication Adherence/*psychology/statistics & numerical data
MH  - Treatment Outcome
MH  - Viral Load
EDAT- 2010/03/20 06:00
MHDA- 2011/04/01 06:00
CRDT- 2010/03/20 06:00
PHST- 2010/03/20 06:00 [entrez]
PHST- 2010/03/20 06:00 [pubmed]
PHST- 2011/04/01 06:00 [medline]
AID - 10.1097/QAD.0b013e32833847af [doi]
PST - ppublish
SO  - AIDS. 2010 May 15;24(8):1153-62. doi: 10.1097/QAD.0b013e32833847af.