Poor quality of life and incomplete self-reported adherence predict second-line ART virological failure in resource-limited settings.

Journal: AIDS care

Volume: 33

Issue: 10

Year of Publication: 2021

Affiliated Institutions:  LapClin-AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-FIOCRUZ), Rio de Janeiro, Brazil. Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA. Asociación Civil Impacta Salud y Educación, Lima, Peru. Blantyre CRS, Blantyre, Malawi. Perinatal HIV Research Unit, Soweto, South Africa. Byramjee-Jeejeebhoy Medical College, Pune, Maharashtra, India. Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Abstract summary 

We evaluated health-related quality of life (QoL) and self-reported incomplete adherence as predictors of early second-line antiretroviral (ART) virological failure (VF). ACTG A5273 study participants completed the ACTG SF-21 measure which has 8 QoL domains. We used exact logistic regression to assess the association of QoL at baseline and week 4 with early VF adjusted for self-reported adherence. Of 500 individuals (51% women, median age 39 years) in this analysis, 79% and 75% self-reported complete adherence (no missing doses in the past month) at weeks 4 and 24, respectively. Early VF was experienced by 7% and more common among those who self-reported incomplete adherence. Participants with low week 4 QoL scores had higher rates of early VF than participants with high scores. After adjusting for self-reported adherence at week 4, VL and CD4 at baseline, cognitive functioning, pain and mental health domains were significantly associated with subsequent early VF. In this post-hoc analysis, poorer QoL adds to self-reported incomplete adherence after 4 weeks of second-line ART in predicting VF at week 24. Evaluation is needed to assess whether individuals with poorer QoL might be targeted for greater support to reduce risk of VF. ClinicalTrials.gov identifier: NCT01352715.

Authors & Co-authors:  Torres Thiago S TS Harrison Linda J LJ La Rosa Alberto M AM Zheng Lu L Cardoso Sandra W SW Ulaya Godwin G Akoojee Nazim N Kadam Dileep D Collier Ann C AC Hughes Michael D MD

Study Outcome 

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Statistics
Citations :  Anastos K, Schneider MF, Gange SJ, Minkoff H, Greenblatt RM, Feldman J, Levine A, Delapenha R, & Cohen M (2005). The association of race, sociodemographic, and behavioral characteristics with response to highly active antiretroviral therapy in women. Journal of Acquired Immune Deficiency Syndromes, 39(5), 8, 537–544
Authors :  11
Identifiers
Doi : 10.1080/09540121.2021.1874275
SSN : 1360-0451
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
HIV;adherence;antiretroviral therapy;quality of life;second-line therapy;virological failure
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England