HIV/AIDS Drug Adherence: HAART adherence assessed by pharmacy claims predicts survival in HIV/AIDS patients

AIDSWEEKLY Plus; Monday, November 13, 2006
Staff Medical Writers

According to a recent report from the United States, "It is unclear how adherence to highly active antiretroviral therapy (HAART) may best be monitored in large HIV programs in sub-Saharan Africa where it is being scaled up.

"We aimed to evaluate the association between HAART adherence, as estimated by pharmacy claims, and survival in HIV-1-infected South African adults enrolled in a private-sector AIDS management program."

"Of the 6288 patients who began HAART between January 1999 and August 2004, 3805 (61%) were female and 6094 (97%) were black African. HAART adherence was greater than or equal to80 for 3298 patients (52%) and 100% for 1916 patients (30%).

"Women were significantly more likely to have adherence greater than or equal to80% than men (54 vs. 49%, p<0.001). The median (interquartile range) follow-tip time was 1.8 (1.37-2.5) years. As of September 1, 2004, 222 patients had died-a crude mortality rate of 3.5%," reported J.B. Nachega and colleagues at Johns Hopkins University in Baltimore.

"In a multivariate Cox regression model," said researchers, "adherence <80% was associated with lower survival (relative hazard 3.23; 95% confidence interval: 2.37-4.39).

"When medication adherence was divided into 5 strata with a width of 20% each, each stratum had lower survival rates than the adjacent, higher-adherence stratum."

The authors continued, "Among other variables tested, only baseline CD4+ T-cell count was significantly associated with decreased survival in multivariate analysis (relative hazard 5.13; 95% confidence interval: 3.42-7.72, for CD4+ T-cell count less than or equal to50 cells/mcL vs. >200 cells/mcL)."

"Pharmacy-based records may be a simple and effective population-level tool for monitoring adherence as HAART programs in Africa are scaled up," Nachega concluded.

Nachega and colleagues published their study in Journal of Acquired Immune Deficiency Syndromes (Adherence to highly active antiretroviral therapy assessed by pharmacy claims predicts survival in HIV-infected South African adults. J Acquir Immune Defic Syndr. 2006 Sep;43(1):78-84).

For additional information, contact J.B. Nachega, Johns Hopkins University, Bloomberg School Public Health, Dept. of International Health, 615 N Wolfe St., Suite W5031, Baltimore, MD 21205, USA.

Publisher contact information for the Journal of Acquired Immune Deficiency Syndromes is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Baltimore, Maryland, United States, HIV/AIDS, HAART, Drug Adherence, Pharmacy Claims, Survival.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Nachega JB, Hislop M, Dowdy DW, et al., “Adherence to highly active antiretroviral therapy assessed by pharmacy claims predicts survival in HIV-infected South African adults”, J Acquir Immune Defic Syndr. 2006 Sep;43(1):78-84.

PubMED Related articles Search

2006-11-13
AW061105

Copyright © 2006 - Charles Henderson, Publisher. All rights Reserved. Permission to reproduce granted to AEGIS by Charles W. Henderson. Authorization to reproduce for personal use granted granted by C. W. Henderson, Publisher, provided that the fee of US$4.50 per copy, per page is paid directly to the Copyright Clearance Center, 27 Congress Street, Salem, Massachusetts 01970, USA. Published by Charles Henderson, Publisher. Editorial & Publishing Office: P.O. Box 5528, Atlanta, GA 30307-0528 / Telephone: (800) 633-4931; Subscription Office: P.O. Box 830409, Birmingham, AL 35283-0409 / FAX: (205) 995-1588 http://www.newsrx.net

AEGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, Bridgestone/Firestone Charitable Trust, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright © 1980,2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.