Association of adherence to Mycobacterium avium complex prophylaxis and antiretroviral therapy with clinical outcomes in acquired immunodeficiency syndrome

被引:23
作者
Cohn, SE
Kammann, E
Williams, P
Currier, JS
Chesney, MA
机构
[1] Univ Rochester, Med Ctr, Dept Med, Infect Dis Unit, Rochester, NY 14642 USA
[2] Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA
[3] Harvard Univ, Sch Publ Hlth, Ctr Biostat AIDS Res, Boston, MA 02115 USA
[4] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA
[5] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
关键词
D O I
10.1086/339542
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
High-level adherence to regimens of combination antiretroviral therapy and prophylactic medications for opportunistic infections (OIs) is crucial to their success. However, little is known about the association between adherence to these life-sustaining therapies and such clinical outcomes as progression of acquired immune deficiency syndrome (AIDS) or development of OIs. We assessed adherence to regimens of antiretroviral and Mycobacterium avium complex (MAC) prophylactic medications in 643 patients enrolled in a trial of MAC prophylaxis. By week 56 of the study follow-up, 42% of the patients reported nonadherence to MAC prophylaxis, whereas one-quarter of the patients reported nonadherence to potent antiretroviral regimens. Nonadherence to both MAC prophylaxis and antiretroviral therapy was associated with higher human immunodeficiency virus (HIV) type 1 RNA levels and a significant increase in the risk of developing an AIDS-defining complication or death. Predictors of nonadherence are presented. These results underscore the clinical significance of adherence to HIV therapy and may be helpful in designing interventions to optimize the management of HIV by improving adherence.
引用
收藏
页码:1129 / 1136
页数:8
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