DI-093 Predictors of non-adherence to highly active antiretroviral therapy in HIV-infected patients

Abstract

Background Highly active antiretroviral therapy (HAART) has significantly reduced morbidity and mortality, transforming HIV into a chronic disease. The increase in life expectancy in these patients has led to a higher prevalence of comorbidities and use of concomitant medicines, which may limit adherence and therapeutic success. Purpose To determine the prevalence of other chronic diseases in HIV-infected patients and to identify predictors of non-adherence to HAART. Material and methods Single-centre retrospective study that included HIV-infected patients on HAART who attended pharmaceutical care at a pharmacy service from January to December 2013. The dependent variable was non-adherence to HAART (patients were considered non-adherent to HAART if the percentage of adherence through dispensing records was ≤90%). The independent variables were: sex, age, number of chronic diseases and concomitant medicines, and the presence of specific diseases (viral liver disease, dyslipidaemia, central nervous system disease, cardiovascular disease or hypertension). Statistical analysis: to identify independent predictors of non-adherence, we performed a multivariate logistic regression analysis. Results A total of 598 patients were analysed. 78.9% were men, mean age was 48 years (IQR: 42–52). The average number of comorbidities per patient was 1.6 ± 1.4. 31.3% of patients had viral liver disease, 17.9% dyslipidaemia, 15.6% central nervous system disease and 14.4% cardiovascular disease or hypertension. The average number of concurrent drugs per patient was 1.9 ± 2.7. 85.3% of patients were adherent to HAART. In the multivariate analysis, presence of viral liver disease was the only variable significantly associated with non-adherence to HAART (OR: 1.81); p = 0.02). The number of chronic diseases and concurrent drugs was not associated with non-adherence. Conclusion The prevalence of other chronic diseases in HIV-infected patients was high. The presence of viral liver disease was identified as a predictor of non-adherence in HIV-patients in this study. Reference Gleason LJ, et al. Polypharmacy in the HIV-infected older adult population. Clin Interv Aging 2013;8:749–63 No conflict of interest.