Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania.

Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Research Abstract Details 

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Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Abstract Text:

Habib O Ramadhani,Nathan M Thielman,Keren Z Landman,Evaline M Ndosi,Feng Gao,Jennifer L Kirchherr,Rekha Shah,Humphrey J Shao,Susan C Morpeth,Jonathan D McNeill,John F Shao,John A Bartlett,John A Crump,Habib O Ramadhani,Nathan M Thielman,Keren Z Landman,Evaline M Ndosi,Feng Gao,Jennifer L Kirchherr,Rekha Shah,Humphrey J Shao,Susan C Morpeth,Jonathan D McNeill,John F Shao,John A Bartlett,John A Crump,

BACKGROUND: Access to antiretroviral therapy is rapidly expanding in sub-Saharan Africa. Identifying the predictors of incomplete adherence, virologic failure, and antiviral drug resistance is essential to achieving long-term success. METHODS: A total of 150 subjects who had received antiretroviral therapy for at least 6 months completed a structured questionnaire and adherence assessment, and plasma human immunodeficiency virus (HIV) RNA levels were measured. Virologic failure was defined as an HIV RNA level >400 copies/mL; for patients with an HIV RNA level >1000 copies/mL, genotypic antiviral drug resistance testing was performed. Predictors were analyzed using bivariable and multivariable logistic regression models. RESULTS: A total of 23 (16%) of 150 subjects reported incomplete adherence. Sacrificing health care for other necessities (adjusted odds ratio [AOR], 19.8; P<.01) and the proportion of months receiving self-funded treatment (AOR, 23.5; P=.04) were associated with incomplete adherence. Virologic failure was identified in 48 (32%) of 150 subjects and was associated with incomplete adherence (AOR, 3.6; P=.03) and the proportion of months receiving self-funded antiretroviral therapy (AOR, 13.0; P=.02). Disclosure of HIV infection status to family members or others was protective against virologic failure (AOR, 0.10; P=.04). CONCLUSIONS: Self-funded treatment was associated with incomplete adherence and virologic failure, and disclosure of HIV infection status was protective against virologic failure. Efforts to provide free antiretroviral therapy and to promote social coping may enhance adherence and reduce rates of virologic failure.

Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Publishing Authors By Initials

HO Ramadhani,NM Thielman,KZ Landman,EM Ndosi,F Gao,JL Kirchherr,R Shah,HJ Shao,SC Morpeth,JD McNeill,JF Shao,JA Bartlett,JA Crump,HO Ramadhani,NM Thielman,KZ Landman,EM Ndosi,F Gao,JL Kirchherr,R Shah,HJ Shao,SC Morpeth,JD McNeill,JF Shao,JA Bartlett,JA Crump,

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Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Clinical infectious diseases : an official publica

VOLUME: 45

Page Numbers: 1492-8

Journal Abbreviation: Clin. Infect. Dis.

ISSN: 1537-6591

DAY: 22

MONTH: 10

YEAR: 2007

Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania. Information

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LANGUAGE: eng

NlmUniqueID: 9203213

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Grant and Affiliation Information for Predictors of incomplete adherence, virologic failure, and antiviral drug resistance among HIV-infected adults receiving antiretroviral therapy in Tanzania.

AFFILIATION: Kilimanjaro Christian Medical Centre, Tumaini University, Moshi, Tanzania.

Country: United States

AGENCY: United States NIGMS

GRANT: R01 GM 065057

ACRONYM: GM

MEDLINETA: Clin Infect Dis

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