Cargando…
Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy
BACKGROUND: Management of co-morbidities among persons living with HIV is an emerging priority, which may require additional medication over and above life-long antiretroviral therapy (ART). We explored factors associated with adherence to the trial drug among children and adolescents with perinatal...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200347/ https://www.ncbi.nlm.nih.gov/pubmed/35704559 http://dx.doi.org/10.1371/journal.pone.0269229 |
_version_ | 1784728041802432512 |
---|---|
author | Rehman, Andrea M. Simms, Victoria McHugh, Grace Mujuru, Hilda Ngwira, Lucky G. Semphere, Robina Moyo, Brewster Bandason, Tsitsi Odland, Jon O. Ferrand, Rashida A. |
author_facet | Rehman, Andrea M. Simms, Victoria McHugh, Grace Mujuru, Hilda Ngwira, Lucky G. Semphere, Robina Moyo, Brewster Bandason, Tsitsi Odland, Jon O. Ferrand, Rashida A. |
author_sort | Rehman, Andrea M. |
collection | PubMed |
description | BACKGROUND: Management of co-morbidities among persons living with HIV is an emerging priority, which may require additional medication over and above life-long antiretroviral therapy (ART). We explored factors associated with adherence to the trial drug among children and adolescents with perinatally acquired HIV taking antiretroviral therapy (ART) in the Bronchopulmonary Function in Response to Azithromycin Treatment for Chronic Lung Disease in HIV-Infected Children (BREATHE) trial. METHODS: The BREATHE trial recruited 6–19 year olds with perinatally acquired HIV and co-morbid chronic lung disease as measured by FEV(1). This two-site trial was individually randomised (1:1), double-blind and placebo-controlled. Participants received a once-weekly weight-based dose of 1–5 tablets of azithromycin (AZM: 250mg) or placebo, taken orally. We used pharmacy dispensing records and count of returned pills to measure adherence to study medication. Logistic regression was used to explore factors associated with adherence coverage. Poisson regression with Lexis expansion for time was used to explore whether adherence modified the effect of azithromycin on the incidence of acute respiratory exacerbation, a secondary outcome of the trial. Trial registration: ClinicalTrials.gov NCT02426112. RESULTS: The 347 participants (median age 15.3, 51% male) consumed 14,622 doses of study medication over 16,220 person-weeks under study. Adherence was higher for those randomised to AZM (73.4%) than placebo (68.4%) and declined over the 48 weeks of the study (Score test for trend <0.02). Those with unsuppressed HIV viral load at baseline had 2.08 (95% CI: 1.19, 3.63) times the odds of non-adherence than those with viral suppression. Differences were also observed between trial sites. CONCLUSION: The majority of children and adolescents tolerated the addition of a once-weekly dose of medication to their pill burden. Barriers in adhering to treatment for co-morbid conditions are likely common to barriers in adhering to ART. Control of co-morbidities will therefore present additional challenges in HIV care. |
format | Online Article Text |
id | pubmed-9200347 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-92003472022-06-16 Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy Rehman, Andrea M. Simms, Victoria McHugh, Grace Mujuru, Hilda Ngwira, Lucky G. Semphere, Robina Moyo, Brewster Bandason, Tsitsi Odland, Jon O. Ferrand, Rashida A. PLoS One Research Article BACKGROUND: Management of co-morbidities among persons living with HIV is an emerging priority, which may require additional medication over and above life-long antiretroviral therapy (ART). We explored factors associated with adherence to the trial drug among children and adolescents with perinatally acquired HIV taking antiretroviral therapy (ART) in the Bronchopulmonary Function in Response to Azithromycin Treatment for Chronic Lung Disease in HIV-Infected Children (BREATHE) trial. METHODS: The BREATHE trial recruited 6–19 year olds with perinatally acquired HIV and co-morbid chronic lung disease as measured by FEV(1). This two-site trial was individually randomised (1:1), double-blind and placebo-controlled. Participants received a once-weekly weight-based dose of 1–5 tablets of azithromycin (AZM: 250mg) or placebo, taken orally. We used pharmacy dispensing records and count of returned pills to measure adherence to study medication. Logistic regression was used to explore factors associated with adherence coverage. Poisson regression with Lexis expansion for time was used to explore whether adherence modified the effect of azithromycin on the incidence of acute respiratory exacerbation, a secondary outcome of the trial. Trial registration: ClinicalTrials.gov NCT02426112. RESULTS: The 347 participants (median age 15.3, 51% male) consumed 14,622 doses of study medication over 16,220 person-weeks under study. Adherence was higher for those randomised to AZM (73.4%) than placebo (68.4%) and declined over the 48 weeks of the study (Score test for trend <0.02). Those with unsuppressed HIV viral load at baseline had 2.08 (95% CI: 1.19, 3.63) times the odds of non-adherence than those with viral suppression. Differences were also observed between trial sites. CONCLUSION: The majority of children and adolescents tolerated the addition of a once-weekly dose of medication to their pill burden. Barriers in adhering to treatment for co-morbid conditions are likely common to barriers in adhering to ART. Control of co-morbidities will therefore present additional challenges in HIV care. Public Library of Science 2022-06-15 /pmc/articles/PMC9200347/ /pubmed/35704559 http://dx.doi.org/10.1371/journal.pone.0269229 Text en © 2022 Rehman et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Rehman, Andrea M. Simms, Victoria McHugh, Grace Mujuru, Hilda Ngwira, Lucky G. Semphere, Robina Moyo, Brewster Bandason, Tsitsi Odland, Jon O. Ferrand, Rashida A. Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy |
title | Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy |
title_full | Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy |
title_fullStr | Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy |
title_full_unstemmed | Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy |
title_short | Adherence to additional medication for management of HIV-associated comorbidities among older children and adolescents taking antiretroviral therapy |
title_sort | adherence to additional medication for management of hiv-associated comorbidities among older children and adolescents taking antiretroviral therapy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200347/ https://www.ncbi.nlm.nih.gov/pubmed/35704559 http://dx.doi.org/10.1371/journal.pone.0269229 |
work_keys_str_mv | AT rehmanandream adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT simmsvictoria adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT mchughgrace adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT mujuruhilda adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT ngwiraluckyg adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT semphererobina adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT moyobrewster adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT bandasontsitsi adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT odlandjono adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy AT ferrandrashidaa adherencetoadditionalmedicationformanagementofhivassociatedcomorbiditiesamongolderchildrenandadolescentstakingantiretroviraltherapy |