Rodrigues R, Bregido L, Oliveira D, Rossetti D, Orii N, Casseb J, Duarte A; International Conference on AIDS.
Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. ThPeB4978.
R. Rodrigues, Universidade de Sao Paulo, Brazil, Tel.: 55 11 3066.7194, Fax: 55 11 881.7190, E-mail: rohc@usp.br
Introduction: Brazilian laws guarantees free public access to ART with over 50,000 patients being supported. Adherence to ART is considered one of the cornerstones of adequate ART. We analyzed the impact of adherence on laboratory and clinical endpoints. Methods: An open cohort of HIV infected patients were followed at an university public clinic. CD4+ cell counts by flow cytometry (Coulter, US), and plasma viremia by either Nasba Nuclisens (Organon, HOL) or Amplicor (Roche, USA). A simple questionnaire with 4 closed and 1 open of adherence question was performed. Patients were categorized for adherence as regular (Reg) with all doses all days, quasi-regular (qR), for missing up to 4 doses, irregular (Irreg.) for all other irregular regimens and Ign, for no information. Results:Of the 181 patients on ART, Reg Adherence was refereed by 75 (41%) of patients, qR by 35 (19%), Irreg by 53 (29%) and Ign by 18 (10%) patients. A significant increase in CD4+ cell counts was observed only among Reg and qR users (p>0.001) but not among Irreg users. Viremia decrease was observed in all patients post treatment (p>0.0001). Long term clinical and laboratorial outcome were significantly worse in Irreg or Ign adherence patients as compared to those with either Reg or qR adherence. Development of AIDS after 60 days on treatment or death was significantly more frequent among those Irreg and Ign as compared to those on Reg or qR therapy adherence. Reg users had significant lower evolution clinical endpoints, AIDS or death, than did Irreg and Ign adherence. Conclusions: Virological and immunological parameters suggested a similar outcome in both Reg and qR groups. When we analyzed clinical outcomes, only Reg users attained a significant difference to either Irreg or those with an Ign adherence. The value of preparing patients to adherence before ART may be cost effective and have a major impact in response to ART in public services.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Ambulatory Care Facilities
- Anti-HIV Agents
- Antiretroviral Therapy, Highly Active
- Brazil
- CD4 Lymphocyte Count
- HIV
- HIV Infections
- Health Personnel
- Humans
- Treatment Outcome
- immunology
- psychology
Other ID:
UI: 102241454
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