Division of Infectious Disease, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Arch Dis Child. 2009 Dec;94(12):970-3. doi: 10.1136/adc.2008.156232. Epub 2009 Aug 31.
The study was aimed to evaluate the relationship between pharmacy supply, self-reported treatment adherence and HIV viral load in HIV-infected children.
A retrospective (52 weeks) cohort study was conducted through the review of the existing databases. Pharmacy supply was classified as "home delivery" when the medications were delivered home and as "in pharmacy pick-up" when they were picked up at the pharmacy. Adherence was assessed through retrospective (3 days recall) self-report. Fisher's exact model, univariate and multivariate logistic regression analyses were used.
The study collected data on 140 HIV-infected children (<18 years). Adherence, pharmacy supply information and HIV viral loads were obtained from clinical and research databases.
The data from 127 HIV-infected children (60 boys and 67 girls; mean age 9.9 years) were collected.
Complete adherence (100%) was reported in only 24% of patients. With 40% of patients being rarely or never completely adherent, 64% of children achieved undetectable viral loads during the study period.
No association between pharmacy supply and self-reported adherence was found (p = 0.605). Self-reported adherence (p = 0.0328) and age (p = 0.025) were the significant predictors of reaching undetectable viral loads. Adolescents (>13 years) were significantly less likely to reach undetectable viral loads than children under 13 years (odds ratio 0.38; 95% CI 0.16 to 0.89).
In our study, pharmacy supply was not associated with self-reported adherence. Most importantly, adherence and age were significant predictors of reaching undetectable viral loads.
本研究旨在评估药房供应、自我报告的治疗依从性与 HIV 感染儿童 HIV 病毒载量之间的关系。
通过回顾现有数据库进行回顾性（52 周）队列研究。当药物送回家中时，药房供应被归类为“家庭配送”，当药物在药房取用时，药房供应被归类为“在药房取货”。通过回顾性（3 天回忆）自我报告评估依从性。采用 Fisher 确切概率模型、单变量和多变量逻辑回归分析。
该研究收集了 140 名（<18 岁）HIV 感染儿童的数据。从临床和研究数据库中获得了依从性、药房供应信息和 HIV 病毒载量。
收集了 127 名 HIV 感染儿童（60 名男孩和 67 名女孩；平均年龄 9.9 岁）的数据。
仅 24%的患者报告完全依从（100%）。40%的患者很少或从不完全依从，64%的儿童在研究期间达到了不可检测的病毒载量。
药房供应与自我报告的依从性之间没有关联（p=0.605）。自我报告的依从性（p=0.0328）和年龄（p=0.025）是达到不可检测病毒载量的显著预测因子。青少年（>13 岁）与 13 岁以下儿童相比，达到不可检测病毒载量的可能性显著降低（比值比 0.38；95%可信区间 0.16 至 0.89）。
在我们的研究中，药房供应与自我报告的依从性无关。最重要的是，依从性和年龄是达到不可检测病毒载量的显著预测因子。
