Viral suppression and adherence among HIV‐infected children and adolescents on antiretroviral therapy: results of a multicenter study

• Main Authors: Maria L.S. Cruz (Author), Claudete A.A. Cardoso (Author), Mariana Q. Darmont (Author), Edvaldo Souza (Author), Solange D. Andrade (Author), Marcia M. D'Al Fabbro (Author), Rosana Fonseca (Author), Jaime G. Bellido (Author), Simone S. Monteiro (Author), Francisco I. Bastos (Author)
• Format: Book
• Published: Brazilian Society of Pediatrics, 2014-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

2255-5536
10.1016/j.jpedp.2014.04.006