Related Experiment Video
Updated: Sep 12, 2025
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
Factors Associated With Incomplete Adherence to Dolutegravir-Based Antiretroviral Therapy in Southwestern Uganda
Cameron T Nutt1,2,3,4, Winnie R Muyindike5, Victoria Nanfuka5
1Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA.
Background:
Tenofovir/lamivudine/dolutegravir (TLD) is now the most prescribed antiretroviral therapy (ART) regimen worldwide. Although effective and well-tolerated, dolutegravir has been associated with weight gain and neuropsychiatric symptoms. The relationship between these adverse effects and adherence to TLD has not been well characterized.
Methods:
We conducted a secondary analysis of a prospective cohort study that followed 675 adults with HIV for 48 weeks in southwestern Uganda after they either transitioned to TLD from older ART regimens or newly initiated ART with TLD. At study weeks 0, 24, and 48, participants completed questionnaires assessing self-reported adherence, use of non-HIV medications, and symptoms. Clinical parameters related to HIV and opportunistic infections were obtained by chart review. Generalized estimating equation logistic regression models were fit to assess factors associated with incomplete adherence.
Results:
In total, 642 participants (95.1%; median age 44 years; 45.6% female) contributed data for at least two study visits. Incomplete adherence to TLD was rare overall, reported by 54 participants (8.4%) through 48 weeks. Incident headaches were associated with incomplete adherence (aOR 1.68; 95% CI: 1.03 to 2.76; P = 0.04), whereas previous ART experience (aOR 0.38; 95% CI: 0.21 to 0.70; P ≤ 0.01) and prescription of ≥1 non-HIV medication (aOR 0.48; 95% CI: 0.29 to 0.79; P ≤ 0.01) predicted better adherence. We found no relationship between perceived weight gain and incomplete adherence (aOR 0.39; 95% CI: 0.11 to 1.39; P = 0.15).
Conclusions:
Incident headaches were associated with incomplete adherence to TLD in southwestern Uganda, whereas established pill-taking routines were associated with better adherence. Dolutegravir-associated weight gain did not affect adherence in this setting.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:29Factors Affecting Protein-Drug Binding: Patient-Related Factors
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:19Factors Affecting Drug Distribution: Miscellaneous Factors
Age plays a significant role due to differences in body composition among different age groups. Infants, for instance, have a higher proportion of total body water and lower albumin levels, a protein that binds drugs in the bloodstream. This unique composition in infants enhances the...
01:21Factors Affecting Drug Response: Overview
01:18Factors Affecting Protein-Drug Binding: Drug-Related Factors
One crucial factor in drug-protein binding is the drug's lipophilicity or its affinity for fat. More lipophilic drugs tend to have higher binding extents. For example, highly lipophilic drugs like cloxacillin exhibit substantial protein binding, with as much as 95% of the drug binding to proteins. In...