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Treatment Response in Association with Adherence Patterns to Highly Active Antiretroviral Therapy in Pediatric

Amisha Malhotra1, Patricia N Whitley-Williams2, Sunanda Gaur2

  • 1Department of Pediatrics, Division of Infectious Disease, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ, USA malhotam@rwjms.rutgers.edu.

Journal of the International Association of Providers of AIDS Care
|March 19, 2014
PubMed

Insights

Consistent adherence to highly active antiretroviral therapy (HAART) is crucial for managing HIV in children. Altered HAART adherence predicts treatment failure and disease progression, highlighting the need for ongoing monitoring.

Area of Science:

  • Pediatric Infectious Diseases
  • HIV/AIDS Research
  • Immunology

Background:

  • Longitudinal adherence patterns and their impact on treatment outcomes in perinatally HIV-infected children remain understudied.
  • Understanding these patterns is critical for optimizing long-term management strategies.

Purpose of the Study:

  • To assess the relationship between longitudinal adherence to highly active antiretroviral therapy (HAART) and virologic/immunologic responses in perinatally HIV-infected children.
  • To identify specific adherence patterns associated with treatment success or failure.

Main Methods:

  • Retrospective study of 62 perinatally HIV-infected children with documented adherence, viral load, and T-cell data (2008-2009).
  • Categorization of patients into groups based on persistent adherence, nonadherence, or altered adherence patterns.
  • Evaluation of virologic and immunologic outcomes in relation to adherence categories.

Main Results:

  • 50% of patients exhibited altered adherence, while 41.9% showed persistent adherence and 8.1% persistent nonadherence.
  • Persistent adherence was linked to a higher likelihood of sustained virologic suppression.
  • Persistent adherence was also associated with a reduced risk of virologic failure.

Conclusions:

  • Altered adherence to HAART is a significant predictor of persistent virologic failure and high viral loads in perinatally HIV-infected children.
  • Implementing longitudinal adherence assessments can help identify patients at risk for treatment failure and disease progression.
  • Targeting interventions towards individuals with inconsistent adherence patterns may improve long-term outcomes.
Abstract

Keywords:
adherencehighly active antiretroviral therapyperinatal HIVviral load

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