From the Hospital General de Agudos "J.M.Ramos Mejía," Servicio de Inmunocomprometidos/Pediatría. Buenos Aires, Argentina.
Pediatr Infect Dis J. 2018 Apr;37(4):345-348. doi: 10.1097/INF.0000000000001807.
Optimal adherence is critical to achieve the benefits of antiretroviral treatment (ART). The aim of the study is to evaluate the use of mobile devices as a strategy to improve adherence to ART, measured by viral load (VL) in HIV+ patients less than 25 years of age.
A prospective study was conducted in a cohort of HIV+ patients less than 25 years of age. HIV+ patients, on ART, VL >1000 copies/mL, using mobile devices and suboptimal adherence were included. The intervention was based on a mobile generic contact twice a month using text message and Facebook during 32 weeks. Extended communications were generated by the patient. VL was performed before and after the intervention.
Twenty-five patients were included. Three were excluded and 22 patients were enrolled. Mean age was 17.2 ± 6.1 years (range: 6-25); 15 (68%) were female; mean baseline VL was 25,100 copies/mL (range: 1020-500,000 copies/mL), mean log was 4.3 (range: 3-5.7 log). Each participant received a total of 16 contacts; 84% (296) were answered by the patient and 54% (189) of the contacts generated extended communications. After the strategy implementation, 20/22 VL results were available: 13/20 (65%) were undetectable, 14/20 (70%) had VL < 1000 copies/mL and 6/20 (30%) VLs had no changes.
The use of mobile devices and social networks is a valid tool to improve ART adherence in HIV+ pediatric and young adults, evaluated through VL. The strategy is feasible. The reminder messages trigger additional communications between patients and health provider and better engagement with HIV care. Longer follow-up time is needed.
最佳依从性对于实现抗逆转录病毒治疗（ART）的益处至关重要。本研究旨在评估使用移动设备提高 HIV 阳性患者（年龄小于 25 岁）ART 依从性的策略，通过病毒载量（VL）进行评估。
对一组年龄小于 25 岁的 HIV 阳性患者进行前瞻性研究。纳入满足以下条件的 HIV 阳性患者：正在接受 ART，VL＞1000 拷贝/mL，使用移动设备且依从性不佳。干预措施基于在 32 周内每月通过短信和 Facebook 对患者进行两次通用移动联系。通过患者生成扩展通信。在干预前后进行 VL 检测。
共纳入 25 例患者，其中 3 例被排除，22 例患者入组。患者平均年龄为 17.2±6.1 岁（范围：6-25 岁）；15 例（68%）为女性；基线 VL 平均为 25100 拷贝/mL（范围：1020-500000 拷贝/mL），平均对数为 4.3（范围：3-5.7 对数）。每位参与者共收到 16 条联系信息；患者回答了 84%（296 条），其中 54%（189 条）的联系信息生成了扩展通信。实施策略后，有 22 例 VL 结果可供分析：20 例（65%）不可检测，20 例（70%）VL＜1000 拷贝/mL，6 例（30%）VL 无变化。
使用移动设备和社交网络是一种通过 VL 评估提高 HIV 阳性儿科和年轻成人 ART 依从性的有效工具。该策略是可行的。提醒信息触发了患者与医疗服务提供者之间的额外沟通，并更好地参与了 HIV 护理。需要更长的随访时间。
