Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, FXB Building 5th floor, 677 Huntington Ave, Boston, MA, 02115, USA.
Research Department, Children's Diagnostic & Treatment Center, Fort Lauderdale, FL, USA.
AIDS Behav. 2019 Aug;23(8):2109-2120. doi: 10.1007/s10461-019-02468-x.
Antiretroviral (ARV) adherence is critical in monitoring disease response in youth with perinatally-acquired HIV (PHIV). We used pharmacy refill (PR) information for PHIV youth from the PHACS Memory Sub-study to calculate medication availability over 2, 4, and 6 months. PR, a proxy of adherence, was compared with self-reported 7-day adherence in predicting suppressed viral load (SVL < 400 copies/mL) and higher CD4% (≥ 25%). Among 159 PHIV youth, 79% were adherent by 7-day recall, and 62, 55, and 48% by PR over 2, 4, and 6 months, respectively. Agreement between 7-day recall and PR adherence was weak (Kappa = 0.09-0.25). In adjusted logistic regression models, adherence showed associations with SVL for 7-day recall (OR 2.78, 95% CI 1.08, 7.15) and all PR coverage periods (6-month: OR 3.24, 95% CI 1.22, 8.65). Similar associations were observed with higher CD4%. PR measures were predictive of study retention. Findings suggest a possibly independent role of PR adherence measures.
抗逆转录病毒 (ARV) 依从性对于监测母婴传播获得性 HIV (PHIV) 青年的疾病反应至关重要。我们使用 PHACS 记忆子研究中的 PHIV 青年的药房补充 (PR) 信息来计算 2、4 和 6 个月的药物可用性。PR 是依从性的替代指标，用于预测病毒载量抑制 (SVL < 400 拷贝/毫升) 和更高的 CD4%（≥ 25%）。在 159 名 PHIV 青年中，79%通过 7 天回顾法依从，分别有 62%、55%和 48%通过 PR 在 2、4 和 6 个月时依从。7 天回顾法和 PR 依从性之间的一致性较弱（Kappa=0.09-0.25）。在调整后的逻辑回归模型中，依从性与 7 天回顾法的 SVL 相关（OR 2.78，95%CI 1.08，7.15）和所有 PR 覆盖期间（6 个月：OR 3.24，95%CI 1.22，8.65）。更高的 CD4%也有类似的关联。PR 测量值可预测研究保留率。研究结果表明 PR 依从性测量可能具有独立作用。
