Butler Hospital/Alpert Medical School of Brown University, Providence, RI, USA.
AIDS Behav. 2013 Jan;17(1):113-21. doi: 10.1007/s10461-011-0082-0.
Patient and regimen persistence in HIV-infected drug users are largely unknown. We evaluated patterns of medication non-persistence among HIV-infected drug users enrolled in a prospective, 6-month randomized controlled trial of directly administered antiretroviral therapy (DAART). Medication-taking behavior was assessed via direct observation and MEMS data. Of 74 participants who initiated DAART, 59 (80%) subjects were non-persistent with medication for 3 or more consecutive days. Thirty-one participants (42%) had 2 or more episodes of non-persistence. Higher depressive symptoms were strongly associated with non-persistence episodes of ≥ 3 days (AOR: 17.4, P = 0.02) and ≥ 7 days AOR: 5.4, P = 0.04). High addiction severity (AOR 3.2, P = 0.03) was correlated with non-persistence ≥ 7 days, and injection drug use (AOR: 15.2, P = 0.02) with recurrence of non-persistence ≥ 3 days. Time to regimen change was shorter for NNRTI-based regimens compared to PI-based ones (HR: 3.0, P = 0.03). There was no significant association between patterns of patient non-persistence and virological outcomes.
在感染 HIV 的吸毒者中，患者和治疗方案的坚持性在很大程度上是未知的。我们评估了在一项前瞻性、6 个月的直接给予抗逆转录病毒治疗（DAART）随机对照试验中入组的感染 HIV 的吸毒者药物不依从的模式。通过直接观察和 MEMS 数据评估用药行为。在开始接受 DAART 的 74 名参与者中，有 59 名（80%）患者连续 3 天或以上不规律服药。31 名参与者（42%）有 2 次或更多次不规律服药。较高的抑郁症状与≥3 天（AOR：17.4，P=0.02）和≥7 天（AOR：5.4，P=0.04）的不规律服药发作强烈相关。较高的成瘾严重程度（AOR 3.2，P=0.03）与≥7 天的不规律服药相关，注射吸毒（AOR：15.2，P=0.02）与≥3 天的不规律服药复发相关。基于 NNRTI 的方案与基于 PI 的方案相比，方案改变时间更短（HR：3.0，P=0.03）。患者不依从的模式与病毒学结果之间没有显著关联。
