Self-reported nonadherence with antiretroviral drugs predicts persistent condition

Area of Science:

• Infectious Diseases
• Pharmacology
• Public Health

Background:

• Highly active antiretroviral therapy (HAART) is crucial for managing HIV infection.
• Maintaining consistent adherence to HAART is essential for treatment efficacy and preventing drug resistance.
• Understanding factors predicting long-term nonadherence is vital for improving patient outcomes.

Purpose of the Study:

• To identify variables that predict persistent nonadherence to HAART in HIV-infected individuals.
• To analyze factors influencing sustained nonadherence over a one-year period.

Main Methods:

• Prospective study involving 140 HIV patients on HAART in Rome.
• Patient questionnaires assessed adherence, knowledge, and influencing factors at baseline and 1 year.
• Predose protease inhibitor plasma levels were measured.
• Persistent nonadherence defined by self-report at both time points.

Main Results:

• 10% of patients remained persistently nonadherent over one year.
• Younger age (<35 years), prior self-reported nonadherence, and experiencing vomiting or pruritus were significant predictors.
• Odds ratios indicated strong associations for these predictive factors.

Conclusions:

• Previous self-reported nonadherence is a strong predictor of persistent nonadherence.
• Younger patients and those reporting gastrointestinal or skin symptoms face a higher risk of sustained nonadherence.
• These findings can inform targeted interventions to improve long-term HAART adherence.