PMID- 23271897
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121231
LR  - 20211021
IS  - 1177-889X (Electronic)
IS  - 1177-889X (Linking)
VI  - 6
DP  - 2012
TI  - Impact of immune reconstitution inflammatory syndrome on antiretroviral therapy 
      adherence.
PG  - 887-91
LID - 10.2147/PPA.S38897 [doi]
AB  - OBJECTIVE: We determined the impact of immune reconstitution inflammatory 
      syndrome (IRIS) on antiretroviral therapy (ART) adherence in a cohort of 274 
      human immunodeficiency virus (HIV)-infected South African adults initiating ART. 
      METHODS: We carried out a secondary analysis of data from a randomized controlled 
      trial of partially supervised ART in Cape Town, South Africa. Monthly pill count 
      adherence, viral suppression (HIV viral load < 50 c/mL), and IRIS events were 
      documented. Poisson regression was used to identify variables associated with ART 
      adherence below the median in the first 6 months of ART. RESULTS: We enrolled 274 
      patients: 58% women, median age 34 years, median CD4 count 98 cells/muL, 46% World 
      Health Organization clinical stage IV, and 40% on treatment for tuberculosis 
      (TB). IRIS and TB-IRIS developed in 8.4% and 6.6% of patients, respectively. The 
      median cumulative adherence at 6 months for those with an IRIS event vs no IRIS 
      was 95.5% vs 98.2% (P = 0.04). Although not statistically significant, patients 
      developing IRIS had a lower 6-month viral load suppression than those without 
      IRIS (68% vs 80%, P = 0.32). ART adherence below the median of 98% was 
      independently associated with alcohol abuse (relative risk [RR] 1.5; 95% 
      confidence interval [CI] 1.2-1.9; P = 0.003) and IRIS events (RR 1.7; 95% CI 
      1.2-2.2; P = 0.001). CONCLUSION: Although IRIS events were associated with 
      slightly lower adherence rates, overall adherence to ART remained high in this 
      study population. Concerns about IRIS should not deter clinicians from early ART 
      initiation.
FAU - Nachega, Jean B
AU  - Nachega JB
AD  - University of Cape Town, Department of Medicine, Division of Clinical 
      Pharmacology, Cape Town, South Africa ; Johns Hopkins University, Bloomberg 
      School of Public Health, Departments of International Health and Epidemiology, 
      Baltimore, Maryland, USA ; Johns Hopkins University, Center for Tuberculosis 
      Research, Baltimore, Maryland, USA.
FAU - Morroni, Chelsea
AU  - Morroni C
FAU - Chaisson, Richard E
AU  - Chaisson RE
FAU - Goliath, Rene
AU  - Goliath R
FAU - Efron, Anne
AU  - Efron A
FAU - Ram, Malathi
AU  - Ram M
FAU - Maartens, Gary
AU  - Maartens G
LA  - eng
GR  - R01 AI055359/AI/NIAID NIH HHS/United States
PT  - Journal Article
DEP - 20121212
PL  - New Zealand
TA  - Patient Prefer Adherence
JT  - Patient preference and adherence
JID - 101475748
PMC - PMC3526885
OTO - NOTNLM
OT  - ART
OT  - HIV/AIDS
OT  - IRIS
OT  - TB
OT  - adherence
EDAT- 2012/12/29 06:00
MHDA- 2012/12/29 06:01
PMCR- 2012/12/12
CRDT- 2012/12/29 06:00
PHST- 2012/12/29 06:00 [entrez]
PHST- 2012/12/29 06:00 [pubmed]
PHST- 2012/12/29 06:01 [medline]
PHST- 2012/12/12 00:00 [pmc-release]
AID - ppa-6-887 [pii]
AID - 10.2147/PPA.S38897 [doi]
PST - ppublish
SO  - Patient Prefer Adherence. 2012;6:887-91. doi: 10.2147/PPA.S38897. Epub 2012 Dec 
      12.