Treatment Interruption and Variation in Tablet Taking Behaviour Result in Viral Failure: A Case-Control Study from Cape Town, South Africa
2011

Impact of Treatment Interruptions on HIV Treatment Failure

Sample size: 244 publication 10 minutes Evidence: moderate

Author Information

Author(s): Ncaca Lisa-Noelle, Kranzer Katharina, Orrell Catherine

Primary Institution: Desmond Tutu HIV Foundation, University of Cape Town

Hypothesis

How do treatment interruptions and variations in tablet-taking behavior affect the risk of virological failure in patients on antiretroviral therapy?

Conclusion

Treatment interruptions and variations in tablet-taking behavior significantly increase the risk of virological failure, even among patients with high adherence.

Supporting Evidence

  • Cumulative adherence <90% increased the odds of failure by three times.
  • At least one episode of adherence variation >10% increased the odds of failure by two times.
  • Treatment interruptions increased the odds of failure by four times.

Takeaway

If people with HIV stop taking their medicine for a while or don't take it the same way every time, they are more likely to get sick again, even if they usually take their medicine well.

Methodology

A retrospective matched case-control analysis was performed, comparing patients who experienced virological failure with controls matched by time on ART.

Potential Biases

Potential bias due to reliance on self-reported adherence and missing data during a staff shortage.

Limitations

The study could not capture short treatment interruptions and relied solely on tablet counts for adherence measurement.

Participant Demographics

Median age was 32 years, with 73.8% female participants.

Statistical Information

P-Value

0.041

Confidence Interval

95%CI 1.45–11.10

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0023088

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