ABSTRACT
A hospital based interventional study was done at Anti Retroviral Therapy centre (ART) of SMS Medical College during August 2010 to January 2011 with the objectives of finding out the proportion of patients who did not adhere to ART, its associated factors, reasons for non-compliance and determine the effect of reinforced counselling through interpersonal communication addressing patient specific reasons and solution for increasing compliance. There were 2841 HIV patients on ART during study period and on an average 381 (13%) of them did not adhere to ART. Age, literacy, unemployment, presence of co-infections were significantly associated with non-compliance while marital status, sex of patient, area of living, family size, distance from ART centre and type of ART regime were not associated with non-compliance. Reasons stated for not coming to collect drugs or not consuming them were mainly patients were travelling, forget to take the pills, no one was there to accompany them, no money for fare, busy in agriculture or other day to day activities. 100 randomly selected non-compliant patients were offered reinforced counselling with focus on patient specific reasons for non compliance and with an intention to encourage the patients to come up with solutions in prevailing circumstances. 74 patients started taking drugs regularly at the end of study. One patient out of these hundred died during study period.
Subject(s)
Adult , Antiretroviral Therapy, Highly Active/methods , Antiretroviral Therapy, Highly Active/trends , Antiretroviral Therapy, Highly Active/statistics & numerical data , Counseling , Female , Humans , Interpersonal Relations , Male , Medication Adherence/epidemiology , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Middle Aged , Patient Compliance/epidemiology , Patient Compliance/statistics & numerical data , Persuasive Communication , Young AdultABSTRACT
Crianças e adolescentes em uso de terapia antirretroviral de alta atividade(HAART) caracterizam um grupo especialmente vulnerável no contexto daepidemia pelo HIV-1...O presente estudo tem como objetivo avaliar os genes da protease e transcriptase reversa em crianças e adolescentes vivendo comHIV/aids. Foi realizada uma análise retrospectiva... Entre os pacientes expostos às três classes com mais de uma entrada (n=27), não houve aumento de mutação para essas classes em relação a genotipagemimediatamente anterior. A alta proporção de resistência aos IP em subtipos Fobservada nesse estudo sugere que o uso dos IP deve ser avaliado levandoem consideração o possível impacto na resposta terapêutica. Os dadosdesse estudo demonstram uma taxa intermediária de resistência transmitidae uma elevada proporção de casos com resistência entre os pacientes emfalha, embasa a noção de que esta população representa um segmento derisco para a evolução da doença.
Children and adolescents on highly active antiretroviral therapy (HAART)represents a vulnerable group in the context of the HIV-1 epidemic, due tobiological issues and different socio-behavioral aspects such as those relatedto adherence to HAART... A retrospective analysis was made, in samples collected from naïve patients and patients exposed to antiretrovirals(ART) with virological failure...Among patients exposed to the three ART classes with more than one genotyping test (n=27), mutations prevalence seemed to not increase when we compared with the previous genotyping test, however most of patients samples showed resistance to the main ART available for use. The high proportion of resistance to IP among subtype F suggests thatin these cases, the IP administration should be evaluated considering apossible impact on therapeutic response. Our results showed an intermediaterate of transmitted resistance e a high proportion of resistance amongpatients with virological failure, supporting the fact that this populationrepresents more risk to disease progression.