Department of Pharmacy, University of Benin Teaching Hospital, Benin City, Nigeria.
Department of Community Health, University of Benin Teaching Hospital, Benin City, Nigeria.
Ghana Med J. 2020 Mar;54(1):30-35. doi: 10.4314/gmj.v54i1.5.
Non-adherence to highly active antiretroviral therapy (HAART) favours drug resistance and wastes resources. These have negative implications for personal and public health.
To assess adherence levels, the associated factors and its association with increase in CD4 cell count in people living with HIV (PLHIVs).
In a cross-sectional survey, systematically selected adult PLHIVs attending a tertiary hospital in Nigeria self-reported their 28-day adherence to HAART and reasons for missing doses using an interviewer-administered questionnaire. Their 6-month difference in CD4 cell count was also assessed.
The participants totalled 425. Their mean age was 38.6 (SD, 10.1) years and 309 (72.7%) had secondary or tertiary education. The 28-day mean adherence level was 96.8% (SD, 7.9%) and 354 (83.3%) participants had optimal adherence (≥ 95%). Socio-demographic characteristics, side effects and having human reminders were not associated with adherence level, but 100% adherence level since placement on HAART was positively associated with a 6-month increase in CD4 cell count ( < 0.01; OR = 1.87, 95%CI = 1.21 - 2.89). Reasons given by 156 respondents for missing doses included being too busy, 100 (64.1%), forgetting, 85 (54.5%) and sleeping off, 42 (26.9%).
Mean adherence was high and the majority of participants had optimal adherence. "Never missing a dose" was associated with improved CD4 cell counts, indicating better prognosis. Socio-demographic factors, side effects and human reminders were not associated with an increase in adherence. However, as there is no evidence that adherence improvement measures are detrimental, their use is still recommended.
None declared.
不遵医嘱服用高效抗逆转录病毒疗法（HAART）会导致耐药性的产生和资源的浪费，这对个人和公共卫生都会产生负面影响。
评估接受抗逆转录病毒治疗的艾滋病毒感染者（PLHIVs）的依从性水平、相关因素及其与 CD4 细胞计数增加的关系。
采用横断面调查方法，在尼日利亚一家三级医院系统选择成年 PLHIVs，使用访谈者管理的问卷自行报告其 28 天 HAART 依从性和漏服药物的原因。还评估了他们 6 个月的 CD4 细胞计数差异。
共有 425 名参与者，平均年龄为 38.6（标准差为 10.1）岁，其中 309 名（72.7%）接受过中等或高等教育。28 天的平均依从率为 96.8%（标准差为 7.9%），354 名（83.3%）参与者的依从率达到了最佳水平（≥95%）。社会人口统计学特征、副作用和有人提醒与依从性水平无关，但自开始接受 HAART 以来的 100%依从率与 6 个月内 CD4 细胞计数的增加呈正相关（<0.01；比值比=1.87，95%置信区间=1.21-2.89）。156 名受访者漏服药物的原因包括太忙、忘记、睡着等，其中太忙占 100 例（64.1%），忘记占 85 例（54.5%），睡着占 42 例（26.9%）。
平均依从性水平较高，大多数参与者的依从性达到了最佳水平。“从不漏服药物”与 CD4 细胞计数的改善相关，表明预后较好。社会人口统计学因素、副作用和人类提醒与依从性的提高无关。然而，由于没有证据表明改善依从性的措施会产生不良影响，因此仍推荐使用这些措施。
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