High Adherence to Antiretrovirals in HIV+ Zambian Children
Author Information
Author(s): Jessica E. Haberer, Adrian Cook, Sarah A. Walker, Marjorie Ngambi, Alex Ferrier, Veronica Mulenga, Cissy Kityo, Margaret Thomason, Desiree Kabamba, Chifumbe Chintu, Diana M. Gibb, David R. Bangsberg
Primary Institution: Massachusetts General Hospital Center for Global Health
Hypothesis
What factors affect adherence to antiretroviral therapy in HIV-infected children in Zambia?
Conclusion
Adherence among children taking fixed-dose combination ART in sub-Saharan Africa is high, but certain groups are at risk for treatment failure.
Supporting Evidence
- Median adherence was 97.4% by visual analog scale.
- 72.6% of children had HIV-1 RNA <50 copies/ml at 48 weeks.
- Agreement among adherence measures was poor.
- Predictors of poor adherence included changing residence and lack of HIV disclosure.
Takeaway
Kids in Zambia who take HIV medicine usually do a great job, but some things like moving homes or not knowing they have HIV can make it harder for them.
Methodology
Adherence was measured using caregiver reports, clinic and unannounced home-based pill counts, and medication event monitoring systems over a median of 23 months.
Potential Biases
Participants may have been more motivated to adhere due to being part of a clinical trial.
Limitations
The study population was drawn from a clinical trial, which may not represent the general population, and about 10% of participants did not complete the study.
Participant Demographics
Median age was 6 years, with 55% male; many had advanced HIV disease.
Statistical Information
P-Value
0.013
Confidence Interval
95% CI 1.20,10.21
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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