• 作者：C. Valdivia Vadell^a ; P. Soler-Palac&#237 ; n^b ; ^{psoler@vhebron.net} ; A. Mart&#237 ; n-Nalda^b ; M.J. Cabañ ; as Poy^a ; S. Clemente Bautista^a ; M. Espiau Guarner^b ; C. Figueras Nadal^b
• 关键词：Adherencia a la medicació ; n ; Fá ; rmacos antirretrovirales ; Niñ ; o ; Adolescente ; Virus de la inmunodeficiencia humana ; Determinació ; n de concentraciones plasmá ; ticas
• 刊名：Anales de Pediatr铆a
• 出版年：2011
• 期刊代码：pca47_16954033
• 类别：med
• 出版时间：December 2011
• 卷：75
• 期：6
• 页码：380-395
• 文件大小：1001 K

Introduction

Poor adherence to antiretroviral treatment (ART) is the commonest cause of treatment failure in children and adults living with HIV, and this is especially important during adolescence. Therefore, any analysis of ART effectiveness in children should include an evaluation of adherence to ART. The aim of this study is to assess the usefulness of an ART adherence monitoring program in an HIV-infected paediatric population.

Patients and methods

An observational and cross-sectional study was performed, within the framework of the 鈥淗ealth Education Program for Optimising Adherence in Paediatric Patients with HIV鈥? which is part of the 鈥淚 am not alone鈥?project. Adherence was assessed simultaneously by different methods: personal interview, therapeutic drug monitoring, pharmacy dispensing records and evolution of viral load and T CD4+ lymphocyte count.

Results

Twenty patients were included (50%female, median age 14.5 years). Percentage of self-reported full adherence was 90%(95%CI: 70-97.2%); however, the median adherence percentage according to pharmacy dispensing records was significantly lower (83.3%, SD = 32.88). The average of drugs and dosage forms per day were 3.5 (SD = 0.83) and 5.5 (SD = 2.72), respectively. There was an inverse relationship between the number of dosage forms per day and adherence scores (F = 13.8; P = .002). No single method was statistically related to adherence, although therapeutic drug monitoring showed a trend towards significance.

Conclusions

Global adherence to ART was high and was easier with simpler regimens. Self-reported adherence overestimated real adherence to ART in our cohort. The simultaneous use of different methods to assess adherence is recommended in HIV-infected children.