HIV/AIDS

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หัวข้อ : Predicting Factors for HIV Genotypic Resistance Test Results Associated with Poor Adherence

ABSTRACT
 
Objective: To determine the predicting factors for HIV genotypic resistance test results associated with poor
adherence among HIV-infected patients receiving ART and having rebound VL.
Methods: A retrospective study was conducted among HIV-infected patients who received ART and had VL
>2,000 copies/mL at Disease Prevention and Control region 7, Ubonratchathani, between 2010 and 2011.
HIVDR was defined as the test results that showed resistance to at least one drug. Poor adherence was defined
as the test results that showed no HIVDR.
Results: Of the 382 patients that were eligible for the study, 287 had HIV drug resistance and 95 had poor
adherence. Univariate analysis showed that VL > 5 log copies/mL and genotypic test in the year 2011 were
significantly associated with poor adherence (p < 0.05). CD4 cell count < 200 cells/mm3
 and using PI-based
regimens had a trend toward being associated with poor adherence (p < 0.10). Multivariate analysis revealed
that only VL > 5 log copies/mL [adjust OR 4.296; 95%CI, 2.538-7.274; p < 0.001] and genotypic resistance
test in the year 2011 [adjust OR 2.477; 95%CI, 1.263-4.860; p=0.008] were independently associated with
poor adherence.
Conclusion: Among HIV-infected patients receiving ART and having treatment failure, VL > 5 log copies/mL
is a predicting factor for poor adherence. The year 2011 had a higher rate of poor adherence, suggesting
that it is becoming more common. Thus, patients with VL > 5 log copies/mL should be advised to improve
their adherence prior to performing HIV genotypic resistance test. (J Infect Dis Antimicrob Agents 2014;31:9-14.)