Antiretroviral adherence and treatment outcomes among patients living with HIV at an Indonesian HIV clinic: a cross-sectional study / Cumplimiento de los antirretrovirales y resultados del tratamiento entre pacientes que viven con el VIH en una clínica de VIH de Indonesia: un estudio transversal

Objective: This study assessed antiretroviral adherence and treatment outcomes among outpatients with human immunodeficiency virus (HIV). Methods: A cross-sectional study was performed on patients with HIV over 18 years old receiving antiretroviral therapy for at least six months at an Indonesian clinic, from January to March 2021. The previously validated self-reported adherence questionnaire was used to recall antiretroviral use. Viral load and CD4 were indicators of treatment outcomes. Binary logistic regression was used to explore factors associated with nonadherence and poor treatment outcomes. Results: Ninety-five patients were included in the study (male 70.5%, median [interquartile range, IQR] age 35 [29–42] years, and median [IQR] treatment duration 29 [15–49] months). Adherence greater than 95% was observed in 89.5%, 88.4%, 95.8% of the patients in the past week, month, and three months, respectively. Patients with secondary education or lower were associated with low adherence (adjusted odds ratio, aOR: 7.73, 95%CI: 1.12– 53.19). Viral suppression and improved CD4 were observed in 83.2% and 68.4% of the patients, respectively. Taking non-nucleoside reverse transcriptase inhibitors (NNRTIs)-based regimen was associated with viral suppression (aOR: 0.01, 95%CI: 0.00–0.14) as well as high CD4 count (aOR: 0.16, 95%CI: 0.03– 0.83). Being diagnosed with stage 4 of HIV (aOR: 72.38, 95%CI: 3.11–1687.28) and having adherence of 95% or lower (aOR: 68.84, 95%CI: 4.86–974.89) were associated with non-suppressed viral load, and having HIV stage 3 (aOR: 7.81, 95%CI: 1.26–48.40) or 4 (aOR: 26.15, 95%CI: 3.42–200.10) at diagnosis was associated with low CD4. Conclusion: Rates of self-reported adherence and treatment outcomes were high. Secondary education or lower was a predictor of low adherence. Using NNRTIs-based therapy was associated with good treatment outcomes; meanwhile, stage 3 or 4 of HIV at diagnosis and low adherence were predictors of poor outcomes. Therefore, strategies to improve adherence and treatment outcomes are warranted.(AU)

Comparison of Asymmetric Dimethylarginine Levels Between Stages Three, Four, and Five Non-dialysis of Chronic Kidney Disease.

AIM: to determine the differences of ADMA level between stages 3, 4, and 5 non-dialysis of chronic kidney disease (CKD) patients at Outpatient Nephrology Clinic, Dr. Soetomo Hospital. METHODS: a cross-sectional study was conducted on stage 3, 4, and 5 non-dialysis CKD patients at Outpatient Nephrology Clinic, Dr. Soetomo Hospital, Surabaya from January to February 2015. Stages of CKD were determined based on GFR estimation according to 4-variable MDRD formula. Statistical analysis of differences in the levels of ADMA in three subject groups use one-way ANOVA test. RESULTS: seventy-five patients were included in the study. Each group consisted of 25 patients stage 3, 4, and, 5 non-dialysis patients. Mean age of stage 3, stage 4, and stage 5 non-dialysis CKD patients were respectively 57.12 years, 54.80 years and 53.68 years. The mean levels of ADMA in stage 3, stage 4, and 5 were 0.62 (0.11) IU/mL, 0.72 (0.16) IU/mL, and 0.73 (0.18) IU/mL respectively. Analysis of the differences between the groups showed significant differences in ADMA levels (p=0.04), with the highest difference between stage 3 and stage 5. CONCLUSION: comparison of ADMA levels showed significant differences between CKD stages and the level tends to be higher along with increase severity of CKD stages.