TY - JOUR
T1 - Relationship between viral load and behavioral measures of adherence to antiretroviral therapy in children living with human immunodeficiency virus in Latin America
AU - Duarte, Horacio A.
AU - Harris, Donald Robert
AU - Tassiopoulos, Katherine
AU - Leister, Erin
AU - Negrini, Silvia Fabiana Biason de Moura
AU - Ferreira, Flávia Faleiro
AU - Cruz, Maria Letícia Santos
AU - Pinto, Jorge
AU - Allison, Susannah
AU - Hazra, Rohan
AU - Pinto, Jorge A.
AU - Faleiro, Flávia F.
AU - Maia, Marcelle M.
AU - Sperhacke, Rosa Dea
AU - Golin, Nicole
AU - Costamilan, Sílvia Mariani
AU - Pilotto, Jose
AU - Moreira, Luis Felipe
AU - Gomes, Ivete
AU - Santos, Breno Riegel
AU - de Cassia Alves Lira, Rita
AU - Peixoto, Mario Ferreira
AU - Teles, Elizabete
AU - Goldani, Marcelo
AU - da Silva, Carmem Lúcia Oliveira
AU - Zanetello, Margery Bohrer
AU - Kreitchmann, Regis
AU - Scotta, Marcelo Comerlato
AU - Coelho, Debora Fernandes
AU - Mussi-Pinhata, Marisa M.
AU - Cervi, Maria Célia
AU - Isaac, Márcia L.
AU - Sturzbecher, Fernanda Tomé
AU - Moura Negrini, Bento V.
AU - Oliveira, Ricardo Hugo S.
AU - Chermont Sapia, Maria C.
AU - Joao, Esau Custodio
AU - Cruz, Maria Leticia
AU - Sidi, Leon Claude
AU - Gouvêa, Maria Isabel
AU - Saavedra, Mariza Curto
AU - Bressan, Clarisse
AU - Jundi, Fernanda Cavalcanti A.
AU - de Menezes Succi, Regina Celia
AU - Machado, Daisy Maria
AU - Negra, Marinella Della
AU - Queiroz, Wladimir
AU - Lian, Yu Ching
AU - Pavía-Ruz, Noris
AU - Morales-Pérez, Dulce
AU - Ojeda-Diezbarroso, Karla
AU - Alarcón Villaverde, Jorge O.
AU - Díaz, María Castillo
AU - Bertucci, Yolanda
AU - Hance, Laura Freimanis
AU - René Gonin, null
AU - Robert Harris, D.
AU - Hennessey, Roslyn
AU - Krauss, Margot
AU - Li, Sue
AU - Megazzini, Karen
AU - Ortega, Orlando
AU - Korelitz, James
AU - de Sanchez, Sharon Sothern
AU - Stoszek, Sonia K.
AU - Yu, Qilu
AU - Mofenson, Lynne M.
AU - Siberry, George K.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - © 2015 Elsevier Editora Ltda. Few studies have examined antiretroviral therapy adherence in Latin American children. Standardized behavioral measures were applied to a large cohort of human immunodeficiency virus-infected children in Brazil, Mexico, and Peru to assess adherence to prescribed antiretroviral therapy doses during the three days prior to study visits, assess timing of last missed dose, and evaluate the ability of the adherence measures to predict viral suppression. Time trends in adherence were modeled using a generalized estimating equations approach to account for possible correlations in outcomes measured repeatedly in the same participants. Associations of adherence with human immunodeficiency virus viral load were examined using linear regression. Mean enrollment age of the 380 participants was 5 years; 57.6% had undetectable' viral load (<400. copies/mL). At enrollment, 90.8% of participants were perfectly (100%) adherent, compared to 87.6% at the 6-month and 92.0% at the 12-month visit; the proportion with perfect adherence did not differ over time ( p= 0.1). Perfect adherence was associated with a higher probability of undetectable viral load at the 12-month visit (odds ratio. = 4.1, 95% confidence interval: 1.8-9.1; p<. 0.001), but not at enrollment or the 6-month visit ( p>. 0.3). Last time missed any antiretroviral therapy dose was reported as "never" for 52.0% at enrollment, increasing to 60.7% and 65.9% at the 6- and 12-month visits, respectively ( p<. 0.001 for test of trend). The proportion with undetectable viral load was higher among those who never missed a dose at enrollment and the 12-month visit ( p≤. 0.005), but not at the 6-month visit ( p= 0.2). While antiretroviral therapy adherence measures utilized in this study showed some association with viral load for these Latin American children, they may not be adequate for reliably identifying non-adherence and consequently children at risk for viral resistance. Other strategies are needed to improve the evaluation of adherence in this population.
AB - © 2015 Elsevier Editora Ltda. Few studies have examined antiretroviral therapy adherence in Latin American children. Standardized behavioral measures were applied to a large cohort of human immunodeficiency virus-infected children in Brazil, Mexico, and Peru to assess adherence to prescribed antiretroviral therapy doses during the three days prior to study visits, assess timing of last missed dose, and evaluate the ability of the adherence measures to predict viral suppression. Time trends in adherence were modeled using a generalized estimating equations approach to account for possible correlations in outcomes measured repeatedly in the same participants. Associations of adherence with human immunodeficiency virus viral load were examined using linear regression. Mean enrollment age of the 380 participants was 5 years; 57.6% had undetectable' viral load (<400. copies/mL). At enrollment, 90.8% of participants were perfectly (100%) adherent, compared to 87.6% at the 6-month and 92.0% at the 12-month visit; the proportion with perfect adherence did not differ over time ( p= 0.1). Perfect adherence was associated with a higher probability of undetectable viral load at the 12-month visit (odds ratio. = 4.1, 95% confidence interval: 1.8-9.1; p<. 0.001), but not at enrollment or the 6-month visit ( p>. 0.3). Last time missed any antiretroviral therapy dose was reported as "never" for 52.0% at enrollment, increasing to 60.7% and 65.9% at the 6- and 12-month visits, respectively ( p<. 0.001 for test of trend). The proportion with undetectable viral load was higher among those who never missed a dose at enrollment and the 12-month visit ( p≤. 0.005), but not at the 6-month visit ( p= 0.2). While antiretroviral therapy adherence measures utilized in this study showed some association with viral load for these Latin American children, they may not be adequate for reliably identifying non-adherence and consequently children at risk for viral resistance. Other strategies are needed to improve the evaluation of adherence in this population.
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U2 - 10.1016/j.bjid.2015.01.004
DO - 10.1016/j.bjid.2015.01.004
M3 - Article
SN - 1413-8670
SP - 263
EP - 271
JO - Brazilian Journal of Infectious Diseases
JF - Brazilian Journal of Infectious Diseases
ER -
