Viral suppression and adherence among HIV-infected children and adolescents on antiretroviral therapy: results of a multicenter study / Supressão viral e adesão entre crianças e adolescentes vivendo com HIV na terapia antirretroviral: resultados de um estudo multicêntrico
Cruz, Maria L.S.; Cardoso, Claudete A.A.; Darmont, Mariana Q.; Souza, Edvaldo; Andrade, Solange D.; D'Al Fabbro, Marcia M.; Fonseca, Rosana; Bellido, Jaime G.; Monteiro, Simone S.; Bastos, Francisco I..
J. pediatr. (Rio J.);
90(6): 563-571, Nov-Dec/2014. tab
Artículo
en Inglés
| LILACS | ID: lil-729829
OBJECTIVE:
To evaluate treatment adherence among perinatally-infected pediatric human immunodeficiency virus (HIV) patients followed in pediatric centers in Brazil.METHODS:
This was a cross-sectional multicenter study. Medical records were reviewed and adherence scale, assessment of caregivers' quality of life (WHOQOL-BREF), anxiety, depression, and alcohol/substances use/abuse were assessed. Outcomes included self-reported 100% adherence in the last three days and HIV viral load (VL) < 50 copies/mL. Statistical analyses included contingency tables and respective statistics, and multivariable logistic regression.RESULTS:
260 subjects were enrolled 78% children and 22% adolescents; 93% of caregivers for the children and 77% of adolescents reported 100% adherence; 57% of children and 49% of adolescents had VL < 50 copies/mL. In the univariate analyses, HIV diagnosis for screening due to maternal infection, lower caregiver scores for anxiety, and higher scores in physical and psychological domains of WHOQOL-BREF were associated with 100% adherence. Shorter intervals between pharmacy visits were associated with VL < 50 copies/mL (p ≤ 0.01). Multivariable regression demonstrated that caregivers who did not abuse alcohol/other drugs (OR = 0.49; 95% CI 0.27-0.89) and median interval between pharmacy visits < 33 days (OR = 0.97; 95% CI 0.95-0.98) were independently associated with VL < 50 copies/mL; whereas lower caregiver scores for anxiety (OR = 2.57; 95% CI 1.27-5.19) and children's HIV diagnosis for screening due to maternal infection (OR = 2.25; 95% CI 1.12-4.50) were found to be independently associated with 100% adherence.CONCLUSIONS:
Pediatric HIV programs should perform routine assessment of caregivers' quality of life, and anxiety and depression symptoms. In this setting, pharmacy records are essential to help identify less-than-optimal adherence. .
Biblioteca responsable:
BR1.1
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