ABSTRACT
La adherencia al tratamiento constituye actualmente una de las principales preocupaciones en relación al control del VIH/sida, asociándose fuertemente al éxito o fracaso terapéutico. Este estudio muestra la adherencia al tratamiento antirretroviral identificando diversos factores que podrían ser facilitadores u obstáculos por medio de la aplicación de los instrumentos cuantitativo y cualitativo. Objetivo: Validación los instrumentos cuantitativo y cualitativo para determinar los factores que influyen en la adherencia al tratamiento antirretroviral y analizar la percepción del paciente sobre el seguimiento que recibe en el Servicio de Farmacia Integral. Métodos: La investigación es mixta, de corte transversal y de tipo exploratorio, descriptivo. El diseño es no experimental. La validación de los instrumentos se realizará mediante juicio de expertos, se utilizó una prueba piloto para el cuantitativo con 15 pacientes, seleccionados de forma no aleatoria, no probabilística. Para el instrumento cualitativo se utiliza un paciente. Resultados: 98.8% de confiabilidad de los instrumentos cualitativos y 85% cuantitativo. De las conductas o comportamiento individual de los pacientes depende exclusivamente la adherencia terapéutica. La percepción del usuario es buena sobre el desempeño profesional al realizar el seguimiento terapéutico, pero todavía se demuestra que deben incrementarse las acciones para que se logre una verdadera descentralización de la atención. Conclusiones: El instrumento es apto para aplicar a los usuarios, los factores sociodemográficos, comportamiento individual y conductas frente al tratamiento influyen en la adherencia terapéutica(AU)
Adherence to treatment is currently one of the main concerns in relation to the control of HIV / AIDS, strongly associated with therapeutic success or failure. This study shows adherence to antiretroviral treatment by identifying various factors that could be facilitators or obstacles through the application of quantitative and qualitative instruments. Objective: Validation of the quantitative and qualitative instruments to determine the factors that influence adherence to antiretroviral treatment and analyze the patient's perception of the follow-up they receive at the Comprehensive Pharmacy Service. Methods: The research is mixed, cross-sectional and exploratory, descriptive. The design is non-experimental. The validation of the instruments was carried out through expert judgment; a pilot test was used for the quantitative with 15 patients, selected in a non-random, non-probabilistic way. One patient selected for the qualitative instrument. Results: 98.8% reliability of the qualitative instruments and 85% quantitative. The conduct or individual behavior of the patients depends exclusively on therapeutic adherence. The user's perception is good on the professional performance when carrying out the therapeutic follow-up, but it is showing yet, that the actions must be increase so that achieve a true decentralization of care. Conclusions: The instrument is suitable to apply to users, sociodemographic factors, individual behavior and behaviors towards treatment influence therapeutic adherence(AU)
Subject(s)
HIV/drug effects , Anti-Retroviral Agents/therapeutic use , Treatment Adherence and Compliance , Alcohol Drinking , Epidemiology , Communicable Diseases , Life StyleABSTRACT
Background: While treating patients with HIV infection it is important to achieve more than 95% compliance to ART (Antiretroviral Therapy) in order to suppress viral replication.Methods: This was a retrospective, observational, record based study of HIV positive patients undergoing treatment with ZLN (zidovudine 300 mg, lamivudine 150 mg, nevirapine 200 mg) and TLE ( tenofovir 300 mg, lamivudine 150 mg, efavirenz 600 mg) regimens. The treatment charts of the patients fulfilling inclusion and exclusion criteria were reviewed.Results: Analysis of adherence showed that there were 12 patients out of 150 on ZLN regimen and 31 patients out of 150 on TLE regimen were nonadherent to the respective treatments.Conclusions: In this observational study patients on ZLN regimen were showing greater compliance than TLE regimen.
ABSTRACT
Objectives: (i) To study the clinical and immunological profile of HIV infected children attending the ART centre; (ii) To correlate CD4 count with clinical staging at diagnosis; and, iii) To study the clinical and immunological response to antiretroviral treatment. Setting: Antiretroviral therapy (ART) centres of two tertiary care hospitals of Delhi. Patients: 100 children attending the centres between December 2008 to June 2009. Methods: The clinical features, immunological profile (CD4 count) and response to ART were recorded in a structured proforma. Design: Prospective follow-up. Results: Average age of enrolled children was 6.24 y (range 1-14 years) and mode of transmission was parent to child in 92%. Most common clinical presentation was fever (83%), cough (50.8%) and diarrhea (38.9%). Tuberculosis was the most common opportunistic infection seen in 11% of children. 59% of enrolled children were malnourished. Antiretroviral treatment (ART) was initiated in 33 children. Children who were initiated on ART had a significant improvement in both clinical and immunological staging at the 6 months follow up. Immunological response (rise in CD4 count) to ART was better in children with lesser degree of immunosuppression. The measure of agreement between the clinical and immunological stage at presentation was poor. Conclusions: Baseline CD4 counts rather than clinical staging can be a primary determinant for initiation of antiretroviral treatment in HIV infected children.
ABSTRACT
After one year of antiretroviral treatment in 49 HIV-infected children compared to 53 children without, weight for age improved significantly and was highly correlated with baseline immune status and CD4% increase but height for age did not change. Stunting is a common feature of pediatric HIV, both on and off HAART.