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Published on: June 11, 2011
Adherence to antiretroviral therapy in HIV-infected children in Italy
F Albano1, M I Spagnuolo, R Berni Canani
1Department of Pediatrics, University Federico II, Naples, Italy. alfguari@unina.it
Insights
Poor adherence to antiretroviral therapy (ART) is a significant issue in children with HIV. This study found that zidovudine levels were often ineffective when administered at home, highlighting the need for improved compliance strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Antiretroviral therapy (ART) adherence is critical for managing HIV infection in children.
- Children with HIV rely on caregivers for medication administration, posing adherence challenges.
Purpose of the Study:
- To assess adherence to zidovudine therapy in children with symptomatic HIV infection.
- To compare zidovudine blood concentrations achieved through home administration versus hospital administration.
Main Methods:
- Blood samples were collected from children 6 hours after reported home zidovudine administration.
- Zidovudine concentrations were measured via radioimmunoassay.
- Drug levels were also measured 1 and 6 hours after hospital administration for comparison.
Main Results:
- Zidovudine levels were within therapeutic ranges following hospital administration.
- Five out of 10 children exhibited sub-therapeutic zidovudine levels after home administration.
- This indicates poor adherence to prescribed antiretroviral therapy in a significant portion of the pediatric cohort.
Conclusions:
- Direct measurement of zidovudine levels confirms poor adherence in pediatric HIV patients.
- Careful monitoring of adherence is essential for children undergoing antiretroviral therapy.
- Strategies to enhance adherence are crucial for effective long-term management of HIV in children.
Abstract:
Adherence to antiretroviral therapy is a major problem in children with HIV infection, who depend on parents or foster parents for receiving drugs. During an ongoing investigation on intestinal function in children with symptomatic HIV infection who were treated with zidovudine, blood samples were obtained six hours after the administration of zidovudine as reported by the parents and, again, one and six hours after its administration in the hospital, and drug concentration was measured by radioimmunoassay. Both peak and steady state zidovudine levels were within the expected concentration ranges after administration in the hospital. In contrast, they were below the effective concentration in five of the 10 children that reportedly had received the drug at home by the parents. These data directly show poor compliance with antiretroviral therapy in children. Compliance with antiretroviral therapy should be carefully checked in children and strategies are needed to increase full and permanent adherence with antiretroviral therapy by people in charge to administer drugs to HIV-infected children.
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