Rosenstein Leslie D
Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Stop 9044, TX, 75390, Dallas, USA.
Neuropsychol Rev. 2021 Dec;31(4):683-688. doi: 10.1007/s11065-021-09483-7. Epub 2021 Feb 12.
This was a narrative review of the literature pertaining to antiretroviral adherence rates in patients with HIV, with a focus on ADHD as a potential risk for poor adherence. A connection is drawn between the cognitive symptoms of ADHD and risk factors for poor treatment adherence in HIV. Parallel associations between ADHD and poor treatment adherence in patients with diabetes are also discussed. Finally, some of the challenges in measuring medication adherence in patients with HIV are summarized. Future research may assess whether patients with comorbid ADHD and HIV have lower rates of adherence than those with HIV alone. Samples will need to be large to manage other contributing factors such as age; in our clinic, patients with HIV referred for ADHD evaluations tend to be younger than patients with HIV referred for assessment of other neurocognitive conditions. This artifact confounds attempts to compare adherence rates in patients with both ADHD and HIV versus those without, as younger age is independently associated with poorer medication compliance. Future research should also include the development of strategies to help infectious disease clinicians to measure adherence as well as the development of cognitive and behavioral strategies for improving adherence rates in patients at risk for poor medication compliance.
这是一篇关于艾滋病患者抗逆转录病毒治疗依从率的文献综述，重点关注注意力缺陷多动障碍（ADHD）作为依从性差的潜在风险。文中阐述了ADHD的认知症状与艾滋病治疗依从性差的风险因素之间的联系。还讨论了ADHD与糖尿病患者治疗依从性差之间的平行关联。最后总结了测量艾滋病患者药物依从性的一些挑战。未来的研究可以评估合并ADHD和艾滋病的患者的依从率是否低于单纯患有艾滋病的患者。样本量需要足够大，以控制其他影响因素，如年龄；在我们诊所，因ADHD评估而转诊的艾滋病患者往往比因其他神经认知状况评估而转诊的艾滋病患者更年轻。这一因素混淆了比较合并ADHD和艾滋病的患者与未合并者的依从率的尝试，因为年龄较小独立地与较差的药物依从性相关。未来的研究还应包括制定策略，以帮助传染病临床医生测量依从性，以及开发认知和行为策略，以提高有药物依从性差风险的患者的依从率。
