In:
Antiviral Therapy, SAGE Publications, Vol. 13, No. 1 ( 2008-01), p. 77-86
Kurzfassung:
The aim of this study was to explore the predictive value of longitudinal self-reported adherence data on viral rebound. Methods Individuals in the Swiss HIV Cohort Study on combined antiretroviral therapy (cART) with RNA 〈 50 copies/ml over the previous 3 months and who were interviewed about adherence at least once prior to 1 March 2007 were eligible. Adherence was defined in terms of missed doses of cART (0, 1, 2 or 〉 2) in the previous 28 days. Viral rebound was defined as RNA 〉 500 copies/ml. Cox regression models with time-independent and -dependent covariates were used to evaluate time to viral rebound. Results A total of 2,664 individuals and 15,530 visits were included. Across all visits, missing doses were reported as follows: 1 dose 14.7%, 2 doses 5.1%, 〉 2 doses 3.8%, taking 〈 95% of doses 4.5% and missing ≥2 consecutive doses 3.2%. In total, 308 (11.6%) patients experienced viral rebound. After controlling for confounding variables, self-reported non-adherence remained significantly associated with the rate of occurrence of viral rebound (compared with zero missed doses: 1 dose, hazard ratio [HR] 1.03, 95% confidence interval [CI] 0.72–1.48; 2 doses, HR 2.17, 95% CI 1.46–3.25; 〉 2 doses, HR 3.66, 95% CI 2.50–5.34). Several variables significantly associated with an increased risk of viral rebound irrespective of adherence were identified: being on a protease inhibitor or triple nucleoside regimen (compared with a non-nucleoside reverse transcriptase inhibitor), 〉 5 previous cART regimens, seeing a less-experienced physician, taking co-medication, and a shorter time virally suppressed. Conclusions A simple self-report adherence questionnaire repeatedly administered provides a sensitive measure of non-adherence that predicts viral rebound.
Materialart:
Online-Ressource
ISSN:
1359-6535
,
2040-2058
DOI:
10.1177/135965350801300108
Sprache:
Englisch
Verlag:
SAGE Publications
Publikationsdatum:
2008
ZDB Id:
2118396-X
SSG:
15,3
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