药房续药措施在评估青少年 HIV 感染者（PHIV）依从性和预测 HIV 疾病标志物方面的作用。
The Role of Pharmacy Refill Measures in Assessing Adherence and Predicting HIV Disease Markers in Youth with Perinatally-Acquired HIV (PHIV).
机构信息
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.
出版信息
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。
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