Adherence to tablet and liquid formulations of antiretroviral medication for paediatric HIV treatment at an urban clinic in Uganda

Abstract

The majority of children initiating HAART had good adherence when estimated by caregiver self-report and pharmacy refill data but lower adherence when measured by home-visit pill counts. Adherence to tablet formulation of HAART was significantly better than syrup formulation. Medication formulation did not significantly affect viral suppression.

The long-term effectiveness of generic adult fixed-dose combination antiretroviral therapy for HIV-infected Ugandan children

“…These findings support the 2010 WHO recommendation of initiation of ART for children between 24-59 months at CD4<25% and those 5 years and older at CD4 absolute count<350 cells/ mm 3 , which was based on longitudinal data 29,30 . Overall adherence to treatment based on pill counts was high, as previously reported 17 . The majority of children initiating HAART had good adherence (>95%) when estimated by caretaker self-report 17 .…”

“…Overall adherence to treatment based on pill counts was high, as previously reported 17 . The majority of children initiating HAART had good adherence (>95%) when estimated by caretaker self-report 17 . Given the high rate of adherence, we could not examine the effect of poor adherence on virologic failure.…”

“…Drug Adherence: Adherence monitoring was conducted at each follow-up visit and was based on pill counts (dividing the actual number of pills taken by the number of pills prescribed) as presented elsewhere 17 . Additional adherence information was collected from children, depending on their developmental age and disclosure status.…”

Acceptability of different oral formulations in infants and preschool children

“…Hence, the applicability of our findings to children outside this population, for example, children who are feeling ill, who are otherwise fractious or who are from a foreign ethnicity is left for future research. In view of the findings of the teams of Ansah,23 Bagenda,24 and Spomer,3 it is anticipated that our study's findings will equally hold for older children.…”

“…Few studies however, have focussed on the acceptability of oral dosage forms as such. Ansah et al 23 compared tablet with syrup formulations in 155 children from between birth and five years (of age) for the treatment of malaria, and Bagenda et al 24 in 129 children from between 6 months and 12 years of age in case of treatment with highly active anti-retroviral therapy (HAART). Both teams concluded that the tablet formulations resulted in better adherence.…”