P17.25 Impact on compliance with the change of first line anti-retroviral drug regimens among patients attending anteretroviral therapy clinics in blantyre, malawi

Abstract

Introduction Change of any drug regimen impacts on compliance. Malawi changed the first line ARV regimen from stavudine-based (stavudine + lamivudine + nevarapine) to tenofovir-based regimen (tenofovir + lamivudine + efavirenz) because the former was associated with adverse side-effects and poor compliance. This study aimed at assessing the impact of the new ARV regimen on compliance. Methods Using cross-sectional study, 169 participants recruited from 6 ART clinics randomly selected were interviewed to assess views on compliance, side-effects and satisfaction to new regimen. Self-reported data on compliance was complemented with patients’ records at the clinics. Results Compliance was poor in first visits on tenofovir-based regimen but gradually improved. Side-effects like dizziness, drowsiness and nightmares were reported in 56.9%, 24.9%, 23.1% of participants respectively especially during the first weeks and these negatively affected compliance (odds ratio = 1.5). Mean individual adherence was 93.3% on tenofovir-based and 85.5% on stavudine-based regimen (p Value of Conclusion Tenofovir-based regimen has improved long term compliance and has the potential to eliminate suboptimal compliance rates to ARVs being a drug taken once daily. However patients still get transient side-effects especially at the beginning of taking this regimen due to efavirenz as such, regular monitoring and thorough counselling of all patients on the side effects of tenofovir-based regimen and transient nature of side effects is needed. A large scale study to be done to obtain data on long-term side-effects of tenofovir-based regimen most possibly renal impairment due to tenofovir or efavirenz-induced gynecomastia.