AEGiS-Glasgow [PL5.2] Similar adherence rates favour different virologic outcomes according to type of HAART

Seventh International Congress on Drug Therapy in HIV Infection

Glasgow, UK - 14-17 November 2004

[PL5.2] Similar adherence rates favour different virologic outcomes according to type of HAART

Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL5.2

Franco Maggiolo¹, Laura Ravasio², Diego Ripamonti¹, Giampietro Gregis¹, Giampaolo Quinzan¹, Monica Airoldi², Fredy Suter²
¹Division of Infectious Diseases, Unit of Antiviral Therapy, Ospedali Riuniti; ²Division of Infectious Diseases, Ospedali Riunitii, Bergamo, Italy

The influence of adherence on virologic outcome of HAART was prospectively investigated in an ongoing cohort.

560 patients with HIV-RNA < 50 copies/ml while on a stable HAART answered a validated ACTG questionnaire. Answers were collected through a visual analogue scale (VAS) allowing a percentile quantification of adherence. HAART failure was defined as a confirmed HIV-RNA > 500 copies/ml within the following 6 months.

543 patients completed the study. According to a multiple logistic regression model, the only independent predictors of HAART failure were the type of HAART (NN vs PI-based)(P = 0.037) and the rate of adherence (P < 0.0001).Overall the odds ratio for virologic failure comparing NN-treated with PI-treated patients was 0.27 (95% CI 0.11-0.63). This difference was exclusively due to patients showing intermediate adherence ( from > 75 to < 100%) whose odds ratio was 0.15 (95% CI 0.03-0.85). The mean adherence score of patients on OD therapy was significantly higher (P = 0.042) than that of patients on a BID schedule.

Adherence is a major determinant of HAART success and, in our study, highly correlates to virologic success of HAART within the following 6 months. NN-based therapies seem to have a higher degree of forgiveness in those patients with intermediate adherence (>75% but < 100%). Simpler regimens favor a significantly higher level of adherence. VAS is a simply reliable instrument for assessing adherence.

Incidence (%) of HAART failure according to adherence
% adherence	<76%	76-85%	86-95%	>95%
NN-based HAART	10.3	5.6	1.6	2.0
PI-based HAART	23.3	23.5	5.3	3.4
Total	17.4	12.2	4.3	2.4

SESSION 5: ADHERENCE, RESISTANCE, CLINICAL PHARMACOLOGY AND DISEASE MONITORING

2004-11-14
PL5.2

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