Eke Ahizechukwu C
Department of Gynecology & Obstetrics, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 2128, USA.
J Pharm Drug Res. 2022;5(1):585-593. Epub 2022 Jul 2.
Medication adherence to antiretroviral medications is critical during pregnancy in women living with HIV (WLHIV) for multiple reasons. In this study, we report medication adherence to tenofovir alafenamide (TAF) compared to tenofovir disoproxil fumarate (TDF) during pregnancy in WLHIV.
This is a retrospective cohort study of pregnant women living with HIV aged 18-48 years who received either tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF) during pregnancy. Medication adherence was assessed during each visit in all trimesters of pregnancy, and was self-reported. Demographics and outcomes were analyzed using standard statistical tests. Logistic regression analysis models accounting for potential confounders, with adjusted odds-ratios (aORs) and associated 95% confidence intervals were reported.
One hundred women met inclusion criteria, with thirty-four women on TAF and sixty-six women on TDF. While medication adherence was higher in women using TAF compared to TDF, with 76% adherent to TDF vs 83% adherent to TAF; p=0.282, in the 1 trimester; 82% adherent to TDF vs 88% adherent to TAF; p=0.924, in the 2 trimester, and 88% adherent to TDF vs 91% adherent to TAF; p=0.176, in the 3 trimester of pregnancy, these differences in medication adherence were not statistically significant. In the third trimester of pregnancy, multiparous women were more likely to be adherent to TDF/TAF antiretroviral medications compared to nulliparous women - univariable odds ratio, OR 1.31, 95% CI 1.12, 1.57; p<0.05; multivariable (adjusted odds ratio, aOR 1.23, 95% CI 1.08, 1.52; p<0.05).
Pregnant women living with HIV on TDF and TAF achieved high adherence, but medication adherence was better in the third trimester compared to the first or second trimesters of pregnancy. These findings support the need to continually assess medication adherence during pregnancy.
由于多种原因，感染艾滋病毒的孕妇（WLHIV）在孕期坚持服用抗逆转录病毒药物至关重要。在本研究中，我们报告了感染艾滋病毒的孕妇在孕期服用替诺福韦艾拉酚胺（TAF）与替诺福韦酯富马酸盐（TDF）的药物依从性情况。
这是一项对年龄在18至48岁的感染艾滋病毒的孕妇进行的回顾性队列研究，这些孕妇在孕期接受了替诺福韦艾拉酚胺（TAF）或替诺福韦酯富马酸盐（TDF）治疗。在孕期的所有三个阶段的每次就诊时评估药物依从性，由患者自我报告。使用标准统计测试分析人口统计学和结果。报告了考虑潜在混杂因素的逻辑回归分析模型，包括调整后的优势比（aORs）和相关的95%置信区间。
100名女性符合纳入标准，其中34名女性服用TAF，66名女性服用TDF。虽然服用TAF的女性的药物依从性高于服用TDF的女性，服用TDF的依从率为76%，服用TAF的依从率为83%；p = 0.282，在孕早期；服用TDF的依从率为82%，服用TAF的依从率为88%；p = 0.924，在孕中期，以及服用TDF的依从率为88%，服用TAF的依从率为91%；p = 0.176，在孕晚期，但这些药物依从性的差异无统计学意义。在孕晚期，经产妇比初产妇更有可能坚持服用TDF/TAF抗逆转录病毒药物——单变量优势比，OR 1.31，95% CI 1.12，1.57；p < 0.05；多变量（调整后的优势比，aOR 1.23，95% CI 1.08，1.52；p < 0.05）。
感染艾滋病毒且服用TDF和TAF的孕妇药物依从性较高，但与孕早期或孕中期相比，孕晚期的药物依从性更好。这些发现支持在孕期持续评估药物依从性的必要性。
