[Adherence to very active antiretroviral treatment: impact of individualized assessment]

Abstract

Background: To determine if the intervention of individual advice improves adherence and effectiveness to highly active antiretroviral therapy.

Methods: Randomized open trial. Patients treated with zidovudine + lamivudine + indinavir were assigned (2/1) to conventional care or individual advise. Individual advise consists in adaptation to treatment to patient style of live and detailed information of therapy. Adherence were estimated with structured interview and pillo counts and were considered correct when more than 90% of prescribed drugs were taken.

Results: Patients 170, conventional care: 110 and IA: 60.

Follow-up: 24 weeks. Baseline characteristics were similar in both groups. Correct adherence were estimated in 52.7% of conventional care and in 76.7% of individual advise (p = 0.002, relative risk: 1.45; CI 95%: 1.16-1.82). Undetectable viral load (NASBA < 50 copies/ml) in 54.5% of conventional care and in 65% of individual advise (p = 0.18, relative risk: 1.19; CI 95%: 0.93-1.53). Reduction of viral load in the conventional care group 1.02 +/- 0.5 log10/ml, and in the individual advise group 1.98 +/- 0.7 log10/ml.

Conclusion: The individual advice improve adherence with a tendency to improve effectiveness of highly active antiretroviral therapy.