Treatment interruptions predict resistance in HIV-positive individuals purchasing fixed-dose combination antiretroviral therapy in Kampala, Uganda

Oyugi, Jessica H.; Byakika-Tusiime, Jayne; Ragland, Kathleen; Laeyendecker, Oliver; Mugerwa, Roy D.; Kityo, Cissy; Mugyenyi, Peter; Quinn, Thomas C.; Bangsberg, David R.

doi:10.1097/qad.0b013e32802e6bfa

Cited by 241 publications

(247 citation statements)

References 29 publications

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“…Both points have been shown to be a significant cause of drug resistance and ARV failure in Uganda. 27 Third, this patients were adequately counselled for improving adherence by counsellors in this ART centre. Counselling is an important factor for improving adherence to antiretroviral therapy in HIV positive patients.…”

Section: Resultsmentioning

confidence: 99%

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

Parmar

Sharma

Trivedi

2018

Int J Basic Clin Pharmacol

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Background: Infection with human immunodeficiency virus (HIV) and subsequent acquired immunodeficiency syndrome (AIDS) continues to be a major public health problem. Treatment and therapeutic guidelines have evolved over a period of time. Drug utilization study helps to evaluate changing pattern of drug use, compliance with national guidelines and rational use of drugs.Methods: Authors conducted observational, non interventional, descriptive study in outdoor HIV positive patients for one year. We have analysed collected data using descriptive statistics to determine drug use indicators and utilization pattern of drugs.Results: Study showed that average number of drugs per encounter was 3.96. The most commonly prescribed antiretroviral therapy (ART) regime was combination of zidovudine, lamivudine with nevirapine (51.92%). Among antiretroviral drugs prescribed, nucleoside reverse transcriptase inhibitors (49.45%) were the most common drug subclass and lamivudine (33.33%) was the most common antiretroviral drug. Second most common medication class was antibacterial agents (18.77%) and co-trimoxazole (10.11%) was the most common antibacterial agent. The third most commonly prescribed drug class was vitamins namely folic acid and multivitamins (2.63 %). Percentage of encounters with an antibiotic prescribed was 41.46%. Tuberculosis was the most common opportunistic infection. In 90.05% of encounters with ART prescriptions, adherence was more than 95%.Conclusions: Overall the results suggest that the prescribing pattern to be in accordance with national guidelines and reflect changing patterns of drug usage in HIV positive patients in World. Drug use indicators reflect rational approach to prescribing pattern.

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Section: Resultsmentioning

confidence: 99%

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

Parmar

Sharma

Trivedi

2018

Int J Basic Clin Pharmacol

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“…in Malawi, where the fertility rate is 5.7 children per woman 56 -stopping and starting ART may be operationally difficult, increase the hazard of death or progression to AIDS, 57 increase the risk of HIV transmission and select for antiretroviral resistance mutations. 58 Indeed, in one study vertical HIV transmission was observed in 0.7% of the women who initiated ART before becoming pregnant and in 5.7% of the women who started ART during pregnancy. 44 Given the health and prevention benefits of lifelong ART in pregnant women, some have argued that programmes should initiate ART immediately after a woman tests positive.…”

Section: Discussionmentioning

confidence: 99%

Integrating antiretroviral therapy into antenatal care and maternal and child health settings: a systematic review and meta-analysis

Suthar

Hui‐Kang

Beqiri

et al. 2012

Bull. World Health Organ.

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“…However, lack of adherence to highly active antiretroviral therapy (HAART) remains a key challenge to successful management of patients with HIV/AIDS. It is estimated that adherence rates lower than 95% are associated with development of viral resistance to antiretroviral medications (Nachega, Hislop, Dowdy, Chaisson, Regensberg & Maartens, 2007;Oyugi, Byakika-Tusiime, Ragland, Laeyendecker, Mugerwa, Kityo et al, 2007;Wahl & Nowak, 2000). Adherence has been defined as 'the extent to which a person's behaviour (in terms of taking medications, following diets, or executing lifestyle changes) coincides with medical advice' (Haynes, 1979).…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to patients' adherence to antiretroviral treatment in Zambia: a qualitative study

Sanjobo

Frich

Fretheim

2008

SAHARA-J: Journal of Social Aspects of HIV/AIDS

133

135

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Patients' adherence to antiretroviral therapy (ART) is important for effective medical treatment of HIV/AIDS. We conducted a qualitative interview study in the Copperbelt Province of Zambia in 2006. The aim of the study was to explore patients' and health care professionals' perceived barriers and facilitators to patients' adherence to ART. Based on data from individual interviews and focus group interviews with a total of 60 patients and 12 health care professionals, we identified barriers and facilitators related to patients' beliefs and behaviours, the health service, and socio-economic and cultural factors. Among the barriers we identified were lack of communication and information about ART, inadequate time during consultations, lack of follow-up and counselling, forgetfulness, stigma, discrimination and disclosure of HIV status, lack of confidentiality in the treatment centres, and lack of nutritional support.Feeling better, prospects of living longer, family support, information about ART, support for income-generating activities, disclosure of HIV status, prayers and transport support were among the facilitators. Our study suggests that several issues need to be considered when providing ART. Further research is needed to study interactions between patients and their health care providers. Our findings can inform interventions to improve adherence to ART.

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Treatment interruptions predict resistance in HIV-positive individuals purchasing fixed-dose combination antiretroviral therapy in Kampala, Uganda

Cited by 241 publications

References 29 publications

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

A study of utilization pattern of drugs in HIV positive patients at antiretroviral therapy centre of a tertiary care teaching hospital

Integrating antiretroviral therapy into antenatal care and maternal and child health settings: a systematic review and meta-analysis

Barriers and facilitators to patients' adherence to antiretroviral treatment in Zambia: a qualitative study

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