Factors and Temporal Trends Associated With Highly Active Antiretroviral Therapy Discontinuation in the Women's Interagency HIV Study

Abstract

We characterized factors and temporal trends associated with discontinuation of highly active antiretroviral therapy (HAART) among 936 HIV-infected women enrolled in the Women's Interagency HIV Study. A multivariate analysis of post-HAART initiation exposures found that high HIV RNA levels (relative hazard [RH] = 1.36, P < 0.001) and high depressive symptom scores (RH = 1.53, P = 0.012) were associated with HAART discontinuation. The adjusted hazard of discontinuation was higher in the 2 most recent calendar periods compared with the first (RH = 1.61, P = 0.026; RH = 1.56, P = 0.074, respectively). The increasing risk of HAART discontinuation in recent calendar periods and changes in the clinical factors associated with discontinuation reflect ongoing and dynamic shifts in the approach to HAART utilization.

Patterns and Predictors of Changes in Adherence to Highly Active Antiretroviral Therapy: Longitudinal Study of Men and Women

“…Thus, it is possible that depressed women may not have been represented in the current analysis because of the requirement of HAART use at both visits. Given that discontinuation of HAART had been systematically studied in the MACS and WIHS before [35][36][37][38][39], we a priori limited our study to changes in adherence among HAART users.…”

Non‐medically supervised treatment interruptions among participants in a universally accessible antiretroviral therapy programme

“…Continued access to HAART is often limited by patientincurred costs, especially in low-or middle-income countries [5] [7,8]. Furthermore, among individuals who have started on HAART, discontinuation rates have been shown to vary greatly from 6% [9] to 51% at 1 year of follow-up [10][11][12][13]. Given the compelling public health need to ensure that as many people benefit from HAART as possible, trying to re-engage individuals who have initiated HAART but have later interrupted therapy should be seen as a priority.…”

Viral Suppression and Discontinuation Rates have Improved in HIV Patients with Modern Antiretroviral Therapies

“…Barriers to ARV adherence include issues with scheduling, ARV safety concerns, stigma, and family responsibilities [9]. Identified risk factors for treatment discontinuation include young age (<40 years), higher HIV viral levels, AIDS, depression, injection drug use, African American ethnicity, higher burden of HIV symptoms, and diminished CD4 T cell counts response with ARV therapy [10][11][12][13].…”