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Identifying risk of viral failure in treated hiv-infected patients using different measures of adherence: the antiretroviral therapy cohort collaboration

Ingle, Suzanne M. and Crane, Heidi M. and Glass, Tracy R. and Yip, Benita and Lima, Viviane D. and Gill, M. John and Hanhoff, Nikola and Ammassari, Adriana and Mugavero, Michael J. and Tate, Jan P. and Guest, Jodie and Turner, Nicholas L. and May, Margaret T. and Sterne, Jonathan A. C.. (2018) Identifying risk of viral failure in treated hiv-infected patients using different measures of adherence: the antiretroviral therapy cohort collaboration. Journal of clinical medicine, 7 (10). E328.

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Abstract

Adherence to antiretroviral therapy (ART) is critical for successful treatment of Human Immunodeficiency Virus (HIV), but comparisons across settings are difficult because adherence is measured in different ways. We examined utility of different adherence measures for identification of patients at risk of viral failure (VF). Eight cohorts in the ART Cohort Collaboration contributed data from pharmacy refills or self-report questionnaires collected between 1996 and 2013 (; N; = 11689). For pharmacy data (; N; = 7156), we examined associations of percentage adherence during the 1st year of ART with VF (>500 copies/mL) at 1 year. For self-report data (; N; = 4533), we examined 28-day adherence with VF based on closest viral load measure within 6 months after questionnaire date. Since adherence differed markedly by measurement type, we defined different cut-off points for pharmacy (lower <45%, medium 45⁻99%, higher 100%) and self-report (lower ≤95%, medium 96⁻99%, higher 100%) data. Adjusted odds ratios (ORs) for VF in lower and medium, compared to higher adherence groups, were 23.04 (95% CI: 18.44⁻28.78) and 3.84 (3.36⁻4.39) for pharmacy data. For self-report data, they were 3.19 (2.31⁻4.40) and 1.08 (0.80⁻1.46). Both types of measure were strongly associated with VF. Although adherence measurements over longer time-frames are preferable for prediction, they are less useful for intervention.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Medicine > Clinical Research (Reither)
UniBasel Contributors:Glass, Tracy
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Multidisciplinary Digital Publishing Institute
ISSN:2077-0383
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:22 Oct 2018 13:26
Deposited On:22 Oct 2018 13:25

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