[Adverse side effects of antiretroviral therapy: relationship between patients' perception and adherence]

To evaluate the relationship between perceived adverse side effects (AE) and non-adherence associated with highly active antiretroviral therapy (HAART).

For 6 consecutive months, patients taking HAART who came to the Pharmacy Department were interviewed. In the questionnaire they had to answer if they had experienced any AE over the past 6 months, what did they do in response to AE and what was the clinical evolution. Adherence was measured by pill counts or by pharmacy records (when pill counts were not possible).

Of 1,936 interviewed patients, 661 (34.1%) reported AE over the past 6 months. The type of antiretroviral drug regimen and starting, re-starting or changing HAART over the past 6 months were significantly associated with AE. Patients who reported AE were 1.4 times more likely to be non-adherents. The most frequently reported AE were diarrhea followed by central nervous system abnormalities and by other gastrointestinal disturbances. In patients starting HAART, 62% of AE improved or disappeared during the first 4 weeks of therapy.

Patients who report AE have worst adherence. AE are more frequent in patients starting HAART but in most cases they improve with time and/or symptomatic therapy.