Cardiovascular medication adherence testing in patients living with HIV: A single-centre observational study

Area of Science:

• Clinical Medicine
• Pharmacology
• Infectious Diseases

Background:

• People with HIV (PWH) exhibit an elevated risk of cardiovascular disease (CVD) compared to HIV-negative individuals.
• Understanding medication adherence in PWH is crucial for managing CVD risk.

Purpose of the Study:

• To evaluate adherence to cardiovascular disease (CVD) medications in people with HIV (PWH).
• To identify factors associated with non-adherence to CVD medications in PWH.

Main Methods:

• Cross-sectional study conducted at University Hospitals of Leicester NHS Trust (April 2019 - November 2022).
• Recruited PWH on CVD medication; assessed adherence using urinary drug testing (LC-MS/MS).
• Multivariable models identified predictors of non-adherence.

Main Results:

• 162 PWH included; median age 55 years, 63% male, 15 years living with HIV.
• One-third (59/162) of PWH showed non-adherence to at least one prescribed CVD medication.
• Non-adherence to lipid-lowering agents was prevalent (40%). Increased number of CVD medications correlated with higher non-adherence (aOR 1.78).

Conclusions:

• Sub-optimal adherence to CVD medications is common in people with HIV (PWH).
• Improving medication adherence, addressing polypharmacy, and utilizing adherence testing are vital for maximizing treatment benefits, especially statin therapy.