LePrevost Marthe, Green Hannah, Flynn Jacquie, Head Stephen, Clapson Margaret, Lyall Hermione, Novelli Vas, Farrelly Laura, Walker A Sarah, Burger David M, Gibb Diana M
Family Clinic, North West London NHS Trust, London, United Kingdom.
Pediatr Infect Dis J. 2006 Jun;25(6):533-7. doi: 10.1097/01.inf.0000222415.40563.d4.
Data on adherence to and acceptability of once daily lamivudine and abacavir are few.
Twenty-four U.K. human immunodeficiency virus type-1 infected children 2-13 years of age participated in the Pediatric European Network for the Treatment of AIDS (PENTA) 13 single arm, open label pharmacokinetic study of twice (every 12 hours) versus once (every 24 hours) daily lamivudine and abacavir. Caregivers were asked to complete an adherence questionnaire at screening, week 0 (switch once daily to twice daily) and weeks 4, 12 and 24. Acceptability was also assessed at screening and week 24.
Fifteen children were taking lamivudine and abacavir as part of their regimens, 8 lamivudine only and 1 abacavir only. After switching to lamivudine/abacavir every 24 hours, 7 (29%) received once daily regimens for all drugs. Twenty-three (96%) caregivers thought that switching to once daily lamivudine/abacavir would make things a lot/a little easier for their child: 17 (71%) thought it was actually easier after switching. Six mothers with children taking a mixture of twice/once daily drugs changed their mind, whereas all mothers of children on once daily regimens agreed that it was a lot easier. Nonadherence (missing doses in the last 3 days) was reported for 8 of 118 (7%) completed questionnaires; missed doses were reported for every drug in the regimen with reasons such as "not at home," "forgot" or "routine different from normal." However, viral loads in all these children remained <100 copies/mL.
Adherence to once daily abacavir/lamivudine was good with no evidence of an association between nonadherence and virologic rebound. Acceptability of once daily drugs was best when the whole regimen was dosed once daily.
关于每日一次服用拉米夫定和阿巴卡韦的依从性和可接受性的数据较少。
24名年龄在2至13岁、感染了1型人类免疫缺陷病毒的英国儿童参与了欧洲儿科艾滋病治疗网络（PENTA）13的单臂、开放标签药代动力学研究，该研究比较了拉米夫定和阿巴卡韦每日两次（每12小时一次）与每日一次（每24小时一次）的用药情况。研究要求照顾者在筛查时、第0周（从每日一次改为每日两次）以及第4、12和24周完成一份依从性调查问卷。在筛查时和第24周也对可接受性进行了评估。
15名儿童将拉米夫定和阿巴卡韦作为其治疗方案的一部分，8名仅服用拉米夫定，1名仅服用阿巴卡韦。在改为每24小时服用一次拉米夫定/阿巴卡韦后，7名（29%）儿童所有药物均采用每日一次的用药方案。23名（96%）照顾者认为改为每日一次服用拉米夫定/阿巴卡韦会使孩子的情况变得轻松很多/轻松一点：17名（71%）认为换药后实际上更轻松了。6名孩子同时服用每日两次/每日一次混合药物的母亲改变了想法，而所有孩子采用每日一次用药方案的母亲都认为轻松了很多。在118份完成的调查问卷中，有8份（7%）报告了不依从情况（在过去3天漏服药物）；治疗方案中的每种药物都有漏服情况，原因包括“不在家”“忘记了”或“日常安排与往常不同”。然而，所有这些儿童的病毒载量仍<100拷贝/毫升。
每日一次服用阿巴卡韦/拉米夫定的依从性良好，没有证据表明不依从与病毒学反弹之间存在关联。当整个治疗方案都采用每日一次给药时，每日一次用药的可接受性最佳。
