Pao D, Erwin J, Kulasegaram R, Peters B; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. B10348.

St. Thomas' Hospital, London, United Kingdom

BACKGROUND: Efficacy of antiretroviral regimens depends on high levels of adherence, including required dose intervals. Clinical trials tend to exclude people with identified adherence issues, therefore under-representing diverse patient groups. Our study included a high proportion of patients with adherence issues or with cultural diversity, such as Black Africans. METHODS: Entry criteria: HAART naive, CD4<350 cells/mm3, viral load<100,000 copies/ml. Regimen: combivir 1 tab BD and abacavir 300mg BD, dispensed using computerised memory eDEM drug bottles. Demographic and clinical data were collected and a quality of life questionnaire administered. RESULTS: 21 patients enroled of whom 5 were Black African, 2 Black Caribbean and 3 South American. 15 patients completed the study, and 18 were suitable for analysis for ITT [3 patients were lost to follow up at an early stage and were excluded from analysis]. Efficacy: undetectable viral load (<50 copies/ml) at 48 weeks was achieved by 10 patients (67%). The remaining 5 had documented difficulties with adherence. Mean CD4 change at 48 weeks was +134 cells/mm3(range -44 to +288). Intent to treat data showed a mean CD4 change of +106 cells/mm3 (range -180 to +288). Adherence: Dose timing was a problem in 40% of cases, confirmed by the eDEM monitors. At 12 weeks, there was significant discrepancy between patient-reported adherence compared with measured eDEM bottle adherence. Risk factors for non-adherence included shift work and non-disclosure of status to friends and co-residents. CONCLUSION: This simple triple nucleoside regimen was well tolerated and effective in achieving optimal virologic response at 48 weeks. Timing of doses represented a significant problem for some patients. This study emphasises that even groups with anticipated adherence problems can do well with appropriate regimens, but that adequate counselling before and during treatment is required.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Antiretroviral Therapy, Highly Active
• Combivir
• Dideoxynucleosides
• Drug Combinations
• HIV Infections
• HIV Seropositivity
• Humans
• Lamivudine
• Pilot Projects
• Risk Factors
• Viral Load
• Zidovudine
• abacavir

Other ID:

• GWAIDS0018406

UI: 102255904

From Meeting Abstracts