Adherence to antiretroviral therapy in a clinical cohort of HIV-infected children in East Africa
Publication Date
February 21, 2018
Authors
Rachel C. Vreeman, Samuel O. Ayaya, Beverly S. Musick, Constantin T. Yiannoutsos, et al
Volume
13
Issue
2
Pages
e0191848
DOI
https://dx.plos.org/10.1371/journal.pone.0191848
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0191848
Scopus
85042365333
Mendeley
http://www.mendeley.com/research/adherence-antiretroviral-therapy-clinical-cohort-hivinfected-children-east-africa-1
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Mendeley | Further Information

{"title"=>"Adherence to antiretroviral therapy in a clinical cohort of HIV-infected children in East Africa", "type"=>"journal", "authors"=>[{"first_name"=>"Rachel C.", "last_name"=>"Vreeman", "scopus_author_id"=>"14720449300"}, {"first_name"=>"Samuel O.", "last_name"=>"Ayaya", "scopus_author_id"=>"55805383500"}, {"first_name"=>"Beverly S.", "last_name"=>"Musick", "scopus_author_id"=>"6602829353"}, {"first_name"=>"Constantin T.", "last_name"=>"Yiannoutsos", "scopus_author_id"=>"6603801676"}, {"first_name"=>"Craig R.", "last_name"=>"Cohen", "scopus_author_id"=>"56639429900"}, {"first_name"=>"Denis", "last_name"=>"Nash", "scopus_author_id"=>"8882895800"}, {"first_name"=>"Deo", "last_name"=>"Wabwire", "scopus_author_id"=>"51865037300"}, {"first_name"=>"Kara", "last_name"=>"Wools-Kaloustian", "scopus_author_id"=>"10044963000"}, {"first_name"=>"Sarah E.", "last_name"=>"Wiehe", "scopus_author_id"=>"8607741000"}], "year"=>2018, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-85042365333", "pui"=>"620772310", "pmid"=>"29466385", "issn"=>"19326203", "isbn"=>"1111111111", "doi"=>"10.1371/journal.pone.0191848", "sgr"=>"85042365333"}, "id"=>"ef0a5920-d16a-3193-a39e-caa6699127e4", "abstract"=>"Objective To describe antiretroviral therapy (ART) adherence and associated factors for a large HIV-infected pediatric cohort followed by sites of the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) consortium. Methods This study utilized prospectively collected clinical data from HIV-infected children less than 13 years of age who initiated ART within 4 clinical care programs (with 26 clinical sites) in Kenya, Uganda, and Tanzania and were followed for up to 6 years. Programs used one of 3 adherence measures, including 7-day quantitative recall, 7-day categorical recall, and clinician pill assessments. We fit a hierarchical, three-level, logistic-regression model to examine adherence, with observations nested within patient, and patients within the 26 sites providing pediatric HIV data to this analysis. Results In East Africa, 3,304 children, 52.0% male, were enrolled in care and were subsequently observed for a median of 92 weeks (inter-quartile range [IQR] 50.3–145.0 weeks). Median age at ART initiation was 5.5 years ([IQR] 3.0–8.5 years). “Good” adherence, as reported by each clinic’s measures, was extremely high, remaining on average above 90% throughout all years of follow-up. Longer time on ART was associated with higher adherence (adjusted Odds Ratio–aOR–per log-transformed week on ART: 1.095, 95% Confidence Interval–CI–[1.052–1.150].) Patients enrolled in higher-volume programs exhibited higher rates of clinician-assessed adherence (aOR per log-500 patients: 1.174, 95% CI [1.108–1.245]). Significant site-level variability in reported adherence was observed (0.28), with even higher variability among patients (0.71). In a sub-analysis, being an orphan at the start of ART was strongly associated with lower ART adherence rates (aOR: 0.919, 95% CI [0.864–0.976]). Conclusions Self-reported adherence remained high over a median of 1.8 years in HIV care, but varied according to patient-level and site-level factors. Consistent adherence monitoring with validated measures and attention to vulnerable groups is recommended.", "link"=>"http://www.mendeley.com/research/adherence-antiretroviral-therapy-clinical-cohort-hivinfected-children-east-africa-1", "reader_count"=>7, "reader_count_by_academic_status"=>{"Student > Doctoral Student"=>1, "Researcher"=>2, "Student > Postgraduate"=>1, "Other"=>2, "Student > Bachelor"=>1}, "reader_count_by_user_role"=>{"Student > Doctoral Student"=>1, "Researcher"=>2, "Student > Postgraduate"=>1, "Other"=>2, "Student > Bachelor"=>1}, "reader_count_by_subject_area"=>{"Biochemistry, Genetics and Molecular Biology"=>1, "Nursing and Health Professions"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>3, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Mathematics"=>{"Mathematics"=>1}}, "group_count"=>1}

Scopus | Further Information

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