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      Knowledge and adherence to antiretroviral therapy among adult people living with HIV/AIDS treated in the health care centers of the association "Espoir Vie Togo" in Togo, West Africa

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          Abstract

          Background

          The efficiency of antiretroviral therapy (ART) depends on a near perfect level of patients' adherence. The level of adherence of adults HIV-infected patients treated in the HIV/AIDS health care centres of the association "Espoir Vie Togo" in Togo, West Africa is not properly documented. The aim of the present study was to examine by means of self-reports the knowledge, the adherence level and associated factors to antiretroviral therapy (ART) among these patients.

          Methods

          We conducted a cross-sectional survey among adult people living with HIV/AIDS (PLWHA) through a structured questionnaire.

          Results

          A total of 99 patients were enrolled. Among them, 55.6% knew the name of antiretroviral agents of regimens prescribed. All patients had a good knowledge of treatment schedule. The treatment regimens based on 2 NRTIs + 1 NNRTI were used in 90% of patients. The average adherence rate was 89.8% of the total doses prescribed while 62.62% of patients showed an adherence rate of 95% or above. The treated groups were similar in term of median % of medication doses taken according to PLWHA epidemiological characteristics. However, patients reported forgetting (34.9%), travel (25.6%), cost of treatment (13.9%) and side effects (11.6%) as the main factors of missing at least once a dose intake.

          Conclusion

          These results should encourage the association and all the involved actors in the HIV/AIDS's program to strengthen counseling, education and information interventions for HIV-infected patients in order to overcome the potential barriers of poor adherence.

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          Most cited references21

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          Non-adherence to highly active antiretroviral therapy predicts progression to AIDS.

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            Less than 95% adherence to nonnucleoside reverse-transcriptase inhibitor therapy can lead to viral suppression.

            For antiretroviral therapy, the 95% adherence "threshold" is based on nucloside-exposed patients who are receiving partially suppressive, unboosted protease inhibitor regimens. Using unannounced pill counts and electronic medication monitoring, viral suppression is common with a 54%-100% mean adherence level to nonnucleoside reverse-transcriptase-inhibitor regimens. Although perfect adherence is an important goal, viral suppression is possible with moderate adherence to potent regimens.
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              Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance.

              Nonadherence to highly active antiretroviral therapy (HAART) is a major cause of human immunodeficiency virus (HIV) drug resistance; however the level of nonadherence associated with the greatest risk of resistance is unknown. Beginning in February 2000, 195 patients at the Johns Hopkins Outpatient Center (Baltimore, MD) who were receiving HAART and who had HIV loads of <500 copies/mL were recruited into a cohort study and observed for 1 year. At each visit, adherence to HAART was assessed and plasma samples were obtained and stored for resistance testing, if indicated. The overall incidence of viral rebound with clinically significant resistance was 14.5 cases per 100 person-years. By multivariate Cox proportional hazards regression, a cumulative adherence of 70%-89%, a CD4 cell nadir of <200 cells/microL, and the missing of a scheduled clinic visit in the past month were independently associated with an increased hazard of viral rebound with clinically significant resistance. Clinicians and patients must set high adherence goals to avoid the development of resistance.
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                Author and article information

                Journal
                BMC Clin Pharmacol
                BMC Clinical Pharmacology
                BioMed Central
                1472-6904
                2010
                17 September 2010
                : 10
                : 11
                Affiliations
                [1 ]Université de Lomé, Faculté Mixte de Médecine et de Pharmacie, BP 1515, Lomé - Togo
                [2 ]Centre Hospitalier Universitaire de Kara, Service de Pharmacie BP 18 - Kara - Togo
                [3 ]Université de Ouagadougou - UFR/SDS 03 BP 7021 Ouagadougou 03 - Burkina Faso
                [4 ]Espoir Vie Togo, Région Centrale (EVT/RC) - Togo
                Article
                1472-6904-10-11
                10.1186/1472-6904-10-11
                2949664
                20849595
                c619366a-0cdc-4c31-927e-761dc5afe75f
                Copyright ©2010 Potchoo et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 September 2009
                : 17 September 2010
                Categories
                Research Article

                Pharmacology & Pharmaceutical medicine
                Pharmacology & Pharmaceutical medicine

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