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High Current CD4+ T Cell Count Predicts Suboptimal Adherence to Antiretroviral Therapy
High levels of adherence to antiretroviral therapy (ART) are necessary for achieving and maintaining optimal virological suppression, as suboptimal adherence leads to therapy failure and disease progression. It is well known that adherence to ART predicts therapy response, but it is unclear whether...
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| Published in: | PloS one 2015-10, Vol.10 (10), p.e0140791-e0140791 |
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| description | High levels of adherence to antiretroviral therapy (ART) are necessary for achieving and maintaining optimal virological suppression, as suboptimal adherence leads to therapy failure and disease progression. It is well known that adherence to ART predicts therapy response, but it is unclear whether clinical outcomes of ART predict adherence. To examine the predictive power of current CD4+ T cell count for adherence of HIV-infected individuals to ART, we performed a cross-sectional analysis of 133 Dutch HIV patients with electronically measured adherence. In a multivariate analysis adjusting for a number of sociodemographic and clinical variables, high current CD4+ T cell count (>660 cells/mm3) was most strongly associated with lower adherence to ART (assessed as a continuous variable) during a two-month period immediately following the measurements of variables (P = 0.008). The twice-per-day (versus once-per-day) dosing regimen was also significantly associated with lower adherence (P = 0.014). In a second multivariate analysis aimed at determining the predictors of suboptimal ( |
| doi_str_mv | 10.1371/journal.pone.0140791 |
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It is well known that adherence to ART predicts therapy response, but it is unclear whether clinical outcomes of ART predict adherence. To examine the predictive power of current CD4+ T cell count for adherence of HIV-infected individuals to ART, we performed a cross-sectional analysis of 133 Dutch HIV patients with electronically measured adherence. In a multivariate analysis adjusting for a number of sociodemographic and clinical variables, high current CD4+ T cell count (>660 cells/mm3) was most strongly associated with lower adherence to ART (assessed as a continuous variable) during a two-month period immediately following the measurements of variables (P = 0.008). The twice-per-day (versus once-per-day) dosing regimen was also significantly associated with lower adherence (P = 0.014). In a second multivariate analysis aimed at determining the predictors of suboptimal (<100% of the doses taken) adherence, high current CD4+ T cell count was again the strongest independent predictor of suboptimal adherence to ART (P = 0.015), and the twice-per-day dosing regimen remained associated with suboptimal adherence (P = 0.025). The association between suboptimal adherence and virological suppression was significant in patients with high CD4+ T cell counts, but not in patients with low or intermediate CD4+ T cell counts (P = 0.036 and P = 0.52, respectively; P = 0.047 for comparison of the effects of adherence on virological suppression between patients with high vs. low or intermediate CD4+ T cell counts), suggesting that apart from promoting suboptimal adherence, high CD4+ T cell count also strengthens the effect of adherence on virological suppression. Therefore, sustained efforts to emphasize continued adherence are necessary, especially for patients with high CD4+ T cell counts.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0140791</identifier><identifier>PMID: 26468956</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adhesion ; Adult ; AIDS ; Analysis ; Anti-Retroviral Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Behavior modification ; CD4 antigen ; CD4 Lymphocyte Count ; CD4 lymphocytes ; CD4-Positive T-Lymphocytes - pathology ; Continuity (mathematics) ; Cross-Sectional Studies ; Dosage ; Drug therapy ; Female ; Generalized linear models ; Genetic aspects ; High current ; Highly active antiretroviral therapy ; HIV ; HIV Infections - blood ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV-1 ; Human immunodeficiency virus ; Humans ; Immunology ; Infections ; Intervention ; Laboratories ; Lymphocytes ; Lymphocytes T ; Male ; Medication Adherence - statistics & numerical data ; Middle Aged ; Multivariate analysis ; Netherlands - epidemiology ; Patient compliance ; Patients ; Physiological aspects ; Prognosis ; Sociodemographics ; Studies ; Success ; Therapy ; Variables ; Viral Load ; Virology</subject><ispartof>PloS one, 2015-10, Vol.10 (10), p.e0140791-e0140791</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Pasternak et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Pasternak et al 2015 Pasternak et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-d1ac2e7803dff8047be4b8db1e6a6725f3276dd97ffb6f7fd573477d9b58c4e53</citedby><cites>FETCH-LOGICAL-c692t-d1ac2e7803dff8047be4b8db1e6a6725f3276dd97ffb6f7fd573477d9b58c4e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1722473150/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1722473150?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26468956$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Okulicz, Jason F</contributor><creatorcontrib>Pasternak, Alexander O</creatorcontrib><creatorcontrib>de Bruin, Marijn</creatorcontrib><creatorcontrib>Bakker, Margreet</creatorcontrib><creatorcontrib>Berkhout, Ben</creatorcontrib><creatorcontrib>Prins, Jan M</creatorcontrib><title>High Current CD4+ T Cell Count Predicts Suboptimal Adherence to Antiretroviral Therapy</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>High levels of adherence to antiretroviral therapy (ART) are necessary for achieving and maintaining optimal virological suppression, as suboptimal adherence leads to therapy failure and disease progression. It is well known that adherence to ART predicts therapy response, but it is unclear whether clinical outcomes of ART predict adherence. To examine the predictive power of current CD4+ T cell count for adherence of HIV-infected individuals to ART, we performed a cross-sectional analysis of 133 Dutch HIV patients with electronically measured adherence. In a multivariate analysis adjusting for a number of sociodemographic and clinical variables, high current CD4+ T cell count (>660 cells/mm3) was most strongly associated with lower adherence to ART (assessed as a continuous variable) during a two-month period immediately following the measurements of variables (P = 0.008). The twice-per-day (versus once-per-day) dosing regimen was also significantly associated with lower adherence (P = 0.014). In a second multivariate analysis aimed at determining the predictors of suboptimal (<100% of the doses taken) adherence, high current CD4+ T cell count was again the strongest independent predictor of suboptimal adherence to ART (P = 0.015), and the twice-per-day dosing regimen remained associated with suboptimal adherence (P = 0.025). The association between suboptimal adherence and virological suppression was significant in patients with high CD4+ T cell counts, but not in patients with low or intermediate CD4+ T cell counts (P = 0.036 and P = 0.52, respectively; P = 0.047 for comparison of the effects of adherence on virological suppression between patients with high vs. low or intermediate CD4+ T cell counts), suggesting that apart from promoting suboptimal adherence, high CD4+ T cell count also strengthens the effect of adherence on virological suppression. Therefore, sustained efforts to emphasize continued adherence are necessary, especially for patients with high CD4+ T cell counts.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adhesion</subject><subject>Adult</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Anti-Retroviral Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Behavior modification</subject><subject>CD4 antigen</subject><subject>CD4 Lymphocyte Count</subject><subject>CD4 lymphocytes</subject><subject>CD4-Positive T-Lymphocytes - pathology</subject><subject>Continuity (mathematics)</subject><subject>Cross-Sectional Studies</subject><subject>Dosage</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Generalized linear models</subject><subject>Genetic aspects</subject><subject>High current</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV Infections - blood</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infections</subject><subject>Intervention</subject><subject>Laboratories</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Netherlands - epidemiology</subject><subject>Patient compliance</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Prognosis</subject><subject>Sociodemographics</subject><subject>Studies</subject><subject>Success</subject><subject>Therapy</subject><subject>Variables</subject><subject>Viral Load</subject><subject>Virology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNkluLEzEUxwdR3LX6DUQHBFGkdXKZZOZFKPWyhYUVt-5ryCQnbZbppCaZxf32pnZ26cg-SB4Szvmd_7nkZNlLVMwQ4ejjtet9J9vZznUwKxAteI0eZaeoJnjKcEEeH71PsmchXBdFSSrGnmYnmFFW1SU7za7O7HqTL3rvoYv54jP9kK_yBbRtvnB9snz3oK2KIb_sG7eLdivbfK43kHAFeXT5vIvWQ_TuxvrkWyWX3N0-z54Y2QZ4MdyT7OfXL6vF2fT84ttyMT-fKlbjONVIKgy8Kog2pioob4A2lW4QMMk4Lg3BnGldc2MaZrjRJSeUc103ZaUolGSSvT7o7loXxDCSIBDHmHKCyiIRywOhnbwWO5868LfCSSv-GpxfC-mjVS2ICiijAAxjtRdvmpSAlJqkEpUpVZ20Pg3Z-mYLWqWRpZ5HomNPZzdi7W4EZQWnqfZJ9m4Q8O5XDyGKrQ0qTVt24PpD3enPak4S-uYf9OHuBmotUwO2My7lVXtRMacEMc4R3qedPUClo2FrVdofY5N9FPB-FJCYCL_jWvYhiOXlj_9nL67G7NsjdgOyjZvg2j5a14UxSA-g8i4ED-Z-yKgQ-_W_m4bYr78Y1j-FvTr-oPugu30nfwBoIf84</recordid><startdate>20151015</startdate><enddate>20151015</enddate><creator>Pasternak, Alexander O</creator><creator>de Bruin, Marijn</creator><creator>Bakker, Margreet</creator><creator>Berkhout, Ben</creator><creator>Prins, Jan M</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151015</creationdate><title>High Current CD4+ T Cell Count Predicts Suboptimal Adherence to Antiretroviral Therapy</title><author>Pasternak, Alexander O ; de Bruin, Marijn ; Bakker, Margreet ; Berkhout, Ben ; Prins, Jan M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-d1ac2e7803dff8047be4b8db1e6a6725f3276dd97ffb6f7fd573477d9b58c4e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adhesion</topic><topic>Adult</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Anti-Retroviral Agents - therapeutic use</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Behavior modification</topic><topic>CD4 antigen</topic><topic>CD4 Lymphocyte Count</topic><topic>CD4 lymphocytes</topic><topic>CD4-Positive T-Lymphocytes - pathology</topic><topic>Continuity (mathematics)</topic><topic>Cross-Sectional Studies</topic><topic>Dosage</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Generalized linear models</topic><topic>Genetic aspects</topic><topic>High current</topic><topic>Highly active antiretroviral therapy</topic><topic>HIV</topic><topic>HIV Infections - blood</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV-1</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Immunology</topic><topic>Infections</topic><topic>Intervention</topic><topic>Laboratories</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Medication Adherence - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pasternak, Alexander O</au><au>de Bruin, Marijn</au><au>Bakker, Margreet</au><au>Berkhout, Ben</au><au>Prins, Jan M</au><au>Okulicz, Jason F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Current CD4+ T Cell Count Predicts Suboptimal Adherence to Antiretroviral Therapy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-10-15</date><risdate>2015</risdate><volume>10</volume><issue>10</issue><spage>e0140791</spage><epage>e0140791</epage><pages>e0140791-e0140791</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>High levels of adherence to antiretroviral therapy (ART) are necessary for achieving and maintaining optimal virological suppression, as suboptimal adherence leads to therapy failure and disease progression. It is well known that adherence to ART predicts therapy response, but it is unclear whether clinical outcomes of ART predict adherence. To examine the predictive power of current CD4+ T cell count for adherence of HIV-infected individuals to ART, we performed a cross-sectional analysis of 133 Dutch HIV patients with electronically measured adherence. In a multivariate analysis adjusting for a number of sociodemographic and clinical variables, high current CD4+ T cell count (>660 cells/mm3) was most strongly associated with lower adherence to ART (assessed as a continuous variable) during a two-month period immediately following the measurements of variables (P = 0.008). The twice-per-day (versus once-per-day) dosing regimen was also significantly associated with lower adherence (P = 0.014). In a second multivariate analysis aimed at determining the predictors of suboptimal (<100% of the doses taken) adherence, high current CD4+ T cell count was again the strongest independent predictor of suboptimal adherence to ART (P = 0.015), and the twice-per-day dosing regimen remained associated with suboptimal adherence (P = 0.025). The association between suboptimal adherence and virological suppression was significant in patients with high CD4+ T cell counts, but not in patients with low or intermediate CD4+ T cell counts (P = 0.036 and P = 0.52, respectively; P = 0.047 for comparison of the effects of adherence on virological suppression between patients with high vs. low or intermediate CD4+ T cell counts), suggesting that apart from promoting suboptimal adherence, high CD4+ T cell count also strengthens the effect of adherence on virological suppression. Therefore, sustained efforts to emphasize continued adherence are necessary, especially for patients with high CD4+ T cell counts.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26468956</pmid><doi>10.1371/journal.pone.0140791</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | PloS one, 2015-10, Vol.10 (10), p.e0140791-e0140791 |
| issn | 1932-6203 1932-6203 |
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| source | Publicly Available Content Database; PubMed Central |
| subjects | Acquired immune deficiency syndrome Adhesion Adult AIDS Analysis Anti-Retroviral Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Behavior modification CD4 antigen CD4 Lymphocyte Count CD4 lymphocytes CD4-Positive T-Lymphocytes - pathology Continuity (mathematics) Cross-Sectional Studies Dosage Drug therapy Female Generalized linear models Genetic aspects High current Highly active antiretroviral therapy HIV HIV Infections - blood HIV Infections - diagnosis HIV Infections - drug therapy HIV Infections - epidemiology HIV-1 Human immunodeficiency virus Humans Immunology Infections Intervention Laboratories Lymphocytes Lymphocytes T Male Medication Adherence - statistics & numerical data Middle Aged Multivariate analysis Netherlands - epidemiology Patient compliance Patients Physiological aspects Prognosis Sociodemographics Studies Success Therapy Variables Viral Load Virology |
| title | High Current CD4+ T Cell Count Predicts Suboptimal Adherence to Antiretroviral Therapy |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T10%3A16%3A50IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=High%20Current%20CD4+%20T%20Cell%20Count%20Predicts%20Suboptimal%20Adherence%20to%20Antiretroviral%20Therapy&rft.jtitle=PloS%20one&rft.au=Pasternak,%20Alexander%20O&rft.date=2015-10-15&rft.volume=10&rft.issue=10&rft.spage=e0140791&rft.epage=e0140791&rft.pages=e0140791-e0140791&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0140791&rft_dat=%3Cgale_plos_%3EA431677127%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c692t-d1ac2e7803dff8047be4b8db1e6a6725f3276dd97ffb6f7fd573477d9b58c4e53%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1722473150&rft_id=info:pmid/26468956&rft_galeid=A431677127&rfr_iscdi=true |