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Adherence to ART increasing among children with HIV
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The availability of once-daily antiretroviral therapy regimens for HIV has increased treatment adherence among children with HIV, according to recent study findings published in The Pediatric Infectious Disease Journal.
Beatriz Jiménez-Montero, MD, of the department of pediatrics at the Hospital Infanta Sofiá in Madrid, Spain, and colleagues evaluated 165 children on ART therapy in December 2011 to determine if there was an increased in administration of once-daily ART (QD-ART) among these children. Seventy-three patients (median age, 17 years) were on a QD-ART regimen.
In 2002, 0.9% of patients in the study were on QD-ART and this number increased to 5.6% in 2005; 23% in 2008; and 44.2% in 2011 (P<.001). The most common regimen were lamivudine/abacavir/efavirenz in 2002, didanosine/emtricitabine/efavirenz in 2005 and emtricitabine/tenofovir/efavirencz in 2008 and 2011.
Among the patients on QD-ART, median duration was 1.9 years with a median number of two daily pills. Efavirenz-based regimens were the most common regimens (63%) followed by atazanavir (Reyataz, Bristol-Myers Squibb)-based regimens (26%), darunavir (Prezista, Janssen Therapeutics)-based regimens (6.8%), and lopinavir/ritonavir (Kaletra, Abbott)-based regimens (4.1%). Emticitabine/tenofivir/efavirenz was the most common QD regimen (38.4%) followed by lamivudine/abacavir/efavirenz (19.2%).
Seventy-one percent of the patients on QD regimens were given fixed-dose combinations.
Good adherence was reported by 76.7% of patients followed by intermediate (13.7%) and poor (9.6%).
Ninety-two patients were on a twice-daily (BID) regimen. Patients on QD-ART were more likely to be older (P<.001), receive more fixed-dose combinations (P<.001), and take fewer daily pills (P<.001).
“In conclusion, the use of QD therapy has increased over time in HIV-infected children in our setting,” the researchers wrote. “Reduction in pill burden and more availability of fixed-dose combinations of antiretroviral drugs may improve adherence in children and adolescents.”
Disclosure: The study was funded in part by the Fundación para la Investigación y Prevención de SIDA en España and Red Temática de Investigación Cooperativa Sanitaria ISCIII. The researchers report no relevant financial disclosures.
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