Predicting adherence to antiretroviral therapy in HIV-infected patients

Aim. To develop a way for predicting adherence of HIV-infected patients to antiretroviral therapy, applicable in medical practice. Methods. The survey included 280 patients with verified diagnosis of HIV infection stage 3-4B, receiving antiretroviral therapy. Clinical manifestations of HIV infection and laboratory data were evaluated. Psychological testing using a Sheehan self-rating scale of anxiety was conducted. Statistical processing was performed using SPSS (version 17) statistical software package. Results. Among the factors that were not related to the primary disease (HIV), risk factors for non-compliance were: single/unmarried status of the patient and living on parents; no higher education. Factors associated with medical treatments included no motivation for switch from one treatment regimen to another, and a high drug load while receiving therapy (more than 7 pills a day). Presence of polyneuropathy on stage 4B and fever of unknown origin at stage 4B were also affecting compliance to antiretroviral therapy. Among laboratory signs, anemia and the level of viral load (independently on the stage of HIV infection), and the number of CD4+-lymphocytes in stage 4A affected the compliance. Assessment of anxiety in HIV-infected patients by using Sheehan self-rating scale of anxiety was more informative. Conclusion. The questionnaire was formed based on the identified factors. Each of the answers to the questionnaire’s questions is assessed by the coefficients of it influence to the adherence to antiretroviral therapy. The obtained data form the basis of the developed algorithm for determining adherence to antiretroviral therapy.

antiretroviral therapy, HIV infection, compliance, factors of compliance, psychological tests