Nonadherence Increases the Risk of Hospitalization Among HIV-Infected Antiretroviral Naïve Patients Started on HAART

Abstract

Background. Since the advent of highly active antiretroviral therapy (HAART), AIDS-related hospitalizations have decreased. The objective of this study was to assess the impact of adherence on hospitalization among antiretroviral-naïve HIV-infected persons initiating HAART. Methods. Analysis was based on a cohort of individuals initiating HAART between 1996 and 2001. The primary outcome was hospitalization for one or more days. Survival methods were used to assess the impact of adherence on hospitalization. Results. Of 1605 eligible participants, 672 (42%) were hospitalized for one or more days after initiating HAART. Median adherence levels were 92 (IQR: 58, 100) and 100 (IQR: 83, 100) among those ever and never hospitalized, respectively. After controlling for confounders, those with <95% adherence had 1.88 times (95% CI: 1.60, 2.21) higher risk for hospitalization. Conclusions. Suboptimal adherence among HIV-infected patients taking HAART predicts hospitalization. Identifying and addressing factors contributing to poor adherence early in treatment could improve patient care and lower hospitalization costs.

Women and Vulnerability to HAART Non-Adherence: A Literature Review of Treatment Adherence by Gender from 2000 to 2011

“…Ten of the 44 studies (22.7%) reported significant differences in adherence between genders [8,16,31,37,46,65,70,73,78,84]. Of these, nine (90%) [8,16,31,46,65,70,73,78,84] [37] was conducted in Spain and used an adherence cutoff of 80%. It should be noted that the majority of articles did not specify whether there was a significant relationship between gender and adherence, as adherence by gender was not the main focus and/or because there was no significant relationship to report.…”

Influence of Treatment Complexity on Adherence and Incidence of Blips in HIV/HCV Coinfected Patients

“…Nonadherence to therapy is closely associated with incomplete viral suppression and disease progression and is thought to be a risk factor for the development of drug resistance. 22 To date there is no evidence of the influence of treatment complexity on adherence of HIV/HCV coinfected patients. However, there is literature in HIV monoinfected patients.…”

Monitoring adherence to antiretroviral treatment in Brazil: an urgent challenge

“…In addition to providing lower viral replication, high adherence, also provides longer survival, lower incidence AIDS related diseases, fewer hospitalizations 12 , better quality of life 13 , reduction of HIV transmission, and reduced emergence of virus strains resistant to ARV 14 . However, the great variability in the definition of non-adherence used in the studies, both in the cutoff points (ranging from 80 to 100% of prescribed doses), as well as in the evaluated treatment period (from one day up to 12 months) complicates national or international comparisons.…”