Evaluation of inadequate anti-retroviral treatment in patients with HIV/AIDS

Abstract

<jats:p>INTRODUCTION: Since the emergence of antiretroviral therapy, the survival of patients infected with human immunodeficiency virus has increased. Non-adherence to this therapy is directly related to treatment failure, which allows the emergence of resistant viral strains. METHODS: A retrospective descriptive study of the antiretroviral dispensing records of 229 patients from the Center for Health Care, University Hospital, Federal University of Juiz de Fora, Brazil, was conducted between January and December 2009. RESULTS: The study aimed to evaluate patient compliance and determine if there was an association between non-adherence and the therapy. Among these patients, 63.8% were men with an average age of 44.0 ± 9.9 years. The most used treatment was a combination of 2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitor (55.5%) or with 2 protease inhibitors (28.8%). It was found that patients taking lopinavir/ritonavir with zidovudine and lamivudine had a greater frequency of inadequate treatment than those taking atazanavir with zidovudine and lamivudine (85% and 83.3%, respectively). Moreover, when the combination of zidovudine/ lamivudine was used, the patients were less compliant (χ2 = 4.468, 1 degree of freedom, p = 0.035). CONCLUSIONS: The majority of patients failed to correctly adhere to their treatment; therefore, it is necessary to implement strategies that lead to improved compliance, thus ensuring therapeutic efficacy and increased patient survival.</jats:p>

Immunovirological parameters and cytokines in HIV infection

“…In this manner it can be inferred that, for individuals that have access to cARV, the needs are not only the discovery of new medicaments and the implementation of programs that are intend to encourage and stimulate the medication adherence to patients 106 but also the search for new interventions aimed at persistently decreasing immune activation and chronic inflammation 107,108 . After all, studies suggest that the attenuation of inflammation induced principally by products from microbial translocation can promote the improvement of clinical results and, it take together with adequate viral suppression, the AIDS progression and mortality can be reduced 109 .…”

Fatores associados à não adesão aos antirretrovirais em adultos com AIDS nos seis primeiros meses da terapia em Salvador, Bahia, Brasil

“…This may indicate the need for therapeutic schemes which are considered in Brazil as rescue therapy, which is more complex and typically requires a higher number of tablets. It might be considered a threat in both individual and public plans, by respectively compromising the effectiveness of drug therapy, and favoring dissemination of virus that are resistant to the drugs available, in addition to impacting public policies on antiretroviral drug provision, and the health system as a whole 5,11,12,13,14,15 .…”

Terapia Antirretroviral: Um Comparativo Entre Características Epidemiológicas De Pacientes Portadores De Hiv

“…Dessa forma, analisou-se as características sociodemográficas de pacientes portadores de HIV/aids, onde observou-se que a maioria apresentava faixa etária entre 18 e 39 anos. Resultados similares foram verificados em alguns estudos (MACHADO-ALBA; GONZÁLEZ-SANTOS; VIDAL- GUITART, 2011;REIS et al, 2011;GALVÃO et al, 2015), enquanto em outros (FONSECA et al, 2012;FIUZA et al, 2013;NOGUEIRA e SEIDL, 2016;PRADO et al, 2016), verificou-se maior diversidade de informações em relação à idade, com variação de 21 a 66 anos. Em vista dos resultados encontrados, pode-se observar que estes não estão em consonância com o perfil nacional, no qual a maior concentração dos casos de HV/aids no Brasil está atualmente em indivíduos com faixa etária entre 25 e 39 anos (BRASIL, 2015).…”

“…Em relação ao esquema de tratamento prescrito na atual pesquisa, 59,1% das pessoas faziam uso desse esquema, corroborando também com outros estudos (ULTRAMARI et al, 2011;FONSECA et al, 2012;ROMEU et al, 2012;SILVA et al, 2015;PRADO et al, 2016), que além de apresentar pessoas que faziam uso do esquema inicial de tratamento preconizado, também apresentava, como no presente estudo, pessoas que utilizavam dois ITRNs associados a um Inibidor da Protease. Em concordância, um estudo realizado na China demonstrou que o uso combinado de ITRNs e ITRNNs são as principais formas de tratamentos utilizadas, porém, a utilização de Inibidores da Protease é incomum, devido ao custo desses medicamentos (JIAO et al, 2010).…”