Impact of short-term adherence on virological and immunological success of HAART: a case study among French HIV-infected IDUs

• Published in: International journal of STD & AIDS 2001-05, Vol.12 (5), p.324-328
• Main Authors: PRADIER, Christian, CARRIERI, Patrizia, BENTZ, Laurence, SPIRE, Bruno, DELLAMONICA, Pierre, MOREAU, Joel, MOATTI, Jean-Paul
• Format: Article
• Language: English
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active; Antiviral agents; Biological and medical sciences; CD4 Lymphocyte Count; Cohort Studies; Female; France; highly active antiretroviral therapy; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - psychology; HIV Infections - virology; Human immunodeficiency virus; Humans; Male; Medical sciences; Patient Compliance - psychology; Pharmacology. Drug treatments; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - psychology; therapy adherence; Time Factors; Treatment Outcome; Viral Load
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1258/0956462011923165

To evaluate the impact of injection drug users (IDUs) adherence on effectiveness of highly active antiretroviral therapy (HAART), repeated measures of plasma viral load and CD4+ counts before HAART initiation and at last visit in the cohort were studied. Data were collected by means of patient's face-to-face and self-administered questionnaires about adherence to HAART during the week prior to the last visit. Of a total of 119 patients treated with HAART, undetectable viral load was obtained for 55 patients (46.2%) (G3); 34 patients (28.6%) (G2) had a viral load decline > 0.5 log copies/ml but still detectable viral load at last visit in the cohort, while 30 patients (25.2%) (G1) had no decline or decline ≤ 0.5 log copies/ml. Proportion of 100% adherent patients was significantly higher in G3 (83.6%) than in G2 (64.7%) and G1 (56.7%). In spite of differences in virological success and adherence, mean increase in CD4+ counts was similar in G3 (123 ± 160 counts/mm3) and G2 (143 ± 147) while no immunological improvement was observed in G1. For the sub-groups of patients whose limited adherence has implied virological failure but did not impede short-term immunological reconstitution following HAART initiation, decision to switch HAART regimens could be delayed until interventions for improving future adherence have been carried out.