AEGiS-13IAC: Self-reported antiretroviral adherence correlantes with HIV liral load and declines over time.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Self-reported antiretroviral adherence correlantes with HIV liral load and declines over time.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB421)

Mannerheimer S, Friedland G, Matts J, Chen L, Child C, MacArthur R, Kostman J, Brizz B, Chesney M
S. Mannerheimer, Columbia University, Harlem Hospital Center, 506 Lenox Avenue, Room 3101A, New York 10037, United States, Tel.: +1 212 939 2948, Fax: +1 212 939 2968, E-mail: sbm20@columbia.edu

OBJECTIVES: To determine if self-reported adherence (adh) with antiretroviral (AR) therapy correlates with treatment outcome as measured by HIV RNA plasma level and CD4 count and if adh levels are sustained over time among participants in two multi-centered national clinical trials.

METHODS: Participants (pts) in CPCRA 057 and 058, two ongoing, randomized clinical trials comparing AR strategies in AR experienced and naive individuals, completed a structured, confidential, 7-day recall adh self-report form at 1, 4, and 8 mos of follow-up. Adh levels, calculated based on reported adh with each AR medication, were classified as 100%, 80-99% and >80%.

RESULTS: As of 12/31/99, 402 pts completed 1 mo. and 96 completed 8 mos of follow-up. The 402 pts were 17% women, 49% African Americans, 17% Latinos, 17% with injection drug use history and had a mean age of 39. At baseline, median CD4 was 231 cells/mm³ and median plasma log HIV RNA was 5.0 copies/ml. Changes in HIV RNA significantly correlated with adh at all time points. At 8 mos., log HIV RNA and CD4 count varied by adh level as shown below Adherence level (%) D log HIV RNA from baseline %HIV RNA > 50 copies D CD4 count 100 -2.9** 67* +144 ó Ç 80 to 99 -1.9 40 +126 0 to 79 -0.5 9 +16 (** P > 0.001, * P > 0.05, & ó Ç P = 0.07): The % of pts reporting 100% adh was 70% at 1 mo, 63% at 4 mos and 58% at 8 mos (P > 0.05).

CONCLUSION: AR adh, as measured by 7-day self-report, predicts HIV RNA changes and % RNA > 50 copies. AR adh significantly decreased over time, suggesting the need for ongoing adherence support.

Keywords: AEGIS, HIV, HIV Infections, CD4 Lymphocyte Count, Anti-HIV Agents, HIV Seropositivity, HIV Protease Inhibitors, Data Collection, Clinical Trials, Treatment Outcome, Time, Human, Female, methods
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TuOrB421