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. 2014 Sep 9;1(2):ofu079.
doi: 10.1093/ofid/ofu079. eCollection 2014 Sep.

Association of first-line and second-line antiretroviral therapy adherence

Habib O Ramadhani  1 , John A Bartlett  2 , Nathan M Thielman  2 , Brian W Pence  3 , Stephen M Kimani  4 , Venance P Maro  5 , Mtumwa S Mwako  6 , Lazaro J Masaki  7 , Calvin E Mmbando  8 , Mary G Minja  9 , Eileen S Lirhunde  9 , William C Miller  3
Affiliations

Association of first-line and second-line antiretroviral therapy adherence

Habib O Ramadhani et al. Open Forum Infect Dis. .

Abstract

Background: Adherence to first-line antiretroviral therapy (ART) may be an important indicator of adherence to second-line ART. Evaluating this relationship may be critical to identify patients at high risk for second-line failure, thereby exhausting their treatment options, and to intervene and improve patient outcomes.

Methods: Adolescents and adults (n = 436) receiving second-line ART were administered standardized questionnaires that captured demographic characteristics and assessed adherence. Optimal and suboptimal cumulative adherence were defined as percentage adherence of ≥90% and <90%, respectively. Bivariable and multivariable binomial regression models were used to assess the prevalence of suboptimal adherence percentage by preswitch adherence status.

Results: A total of 134 of 436 (30.7%) participants reported suboptimal adherence to second-line ART. Among 322 participants who had suboptimal adherence to first-line ART, 117 (36.3%) had suboptimal adherence to second-line ART compared with 17 of 114 (14.9%) who had optimal adherence to first-line ART. Participants who had suboptimal adherence to first-line ART were more likely to have suboptimal adherence to second-line ART (adjusted prevalence ratio, 2.4; 95% confidence interval, 1.5-3.9).

Conclusions: Adherence to first-line ART is an important predictor of adherence to second-line ART. Targeted interventions should be evaluated in patients with suboptimal adherence before switching into second-line therapy to improve their outcomes.

Keywords: HIV; adherence; antiretroviral.

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Figures

Figure 1.
Figure 1.
Study flow diagram. Selection of HIV-infected adolescents and adults receiving second-line ART at 5 infectious disease clinics in Kilimanjaro Region, Moshi, Tanzania 2004–2013. Abbreviations: ART, antiretroviral therapy; HIV, human immunodeficiency virus.
See this image and copyright information in PMC

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