Dose timing of anti-retroviral drugs among HIV-infected adolescents in a Sub-Saharan tertiary health institution
DOI:
https://doi.org/10.60787/tnhj.v19i1.435Keywords:
dose timing, antiretroviral, adherence, HIV-infected, adolescent.Abstract
Background: The introduction and use of antiretroviral therapy among HIV-infected persons has recorded successes when adherence is kept at a level of ≥95%. Studies show that adherence to the prescribed antiretroviral dose timing is an important factor in achieving this success. The aim of the study was to determine the proportion of HIV-infected adolescents adherent to prescribed dose timing, assess the level of difficulty to adherence to dose timing and identify factors associated with adherence to dose timing of prescribed antiretroviral therapy medications.
Methods: A prospective study design was used to carry out the study in Abuja, Nigeria. Each enroled adolescent was followed up for 6 months at two monthly intervals.
Results: Results from 135 adolescents aged 10 to 19 years were analysed. Majority were males 73 (54.1%), aged 10 to 13 years (n= 76; 56.3%) and Christians (n = 102; 75.6%). One hundred and four (77.03%) adolescents had never had a problem with taking their drugs while 94% were adherent to their scheduled dose timing medication. There was a weak association between adherence to dose timing and the age of the adolescent (p= 0.043 OR= 4.08 CI 0.69-23.2).
Conclusion: The proportion of adolescents adherent to dose timing was high. Majority did not have a problem with taking their ARV medications. It is recommended that dose timing adherence of scheduled ARV medications be assessed routinely along with other adherence measures as studies have shown its importance in viral load suppression and prevention of drug resistance.
Downloads
References
AVERT. HIV and AIDS in Sub-Saharan Africa. 2014. Available at https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/nigeria accessed 15 May 2019.
World Health Organisation. Adherence to Long Term Therapies. WHO Switzerland 2003 p 95.
Clavel F, Hance AJ. HIV drug resistance. N Eng J Med 2004;350:1023–1035.
Bangsberg DR, Perry S, Charlebois ED, Clark RA, Roberston M, et al. Nonadherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS 2001;15:1181–1183.
Jani AA. Adherence to HIV Treatment Regimens: Recommendations for Best Practices. 2004. Available at: http://www.apha.org/NR/rdonlyres/A030DDB1-02C8-4D80-923B-7EF6608D62F1/0/BestPracticesnew.pdf accessed 24 May 2019
Lewis JM, Volny-Anne A, Waitt C, Boffito M, Khoo S. Dosing antiretroviral medication when crossing time zones: a review. AIDS 2016;30: 267 -271.
Liu H, Miller LG, Golin CE, Hays RD, WU T, Wenger NS, Kaplan AH. Repeated measures analyses of dose timing to antiretroviral medication and its relationship to HIV virologic outcomes. Stat Med 2007;26: 991-1007.
Liu H, Miller LG, Golin CE, Hays RD, WU T, Wenger NS, Kaplan AH. Repeated measures longitudinal analyses of HIV virologic response as a function of percent adherence, dose timing, genotypic sensitivity, and other factors. J Acquir Immune Defic Syndr 2006;41: 315-322.
World Health Organisation. Antiretroviral Therapy for HIV Infection in Adults and Adolescents Recommendations for a Public Health Approach. WHO Geneva 2006: 38.
Muller AD, Jaspan HB, Myer L, Hunter AL, Harling G, et al. Standard measures are inadequate to monitor pediatric adherence in a resource-limited setting. AIDS Behav 2011;15:422-431.
Olusanya O, Okpere E, Ezimokhai M. The importance of social class in voluntary fertility control in a developing country. W Afr J Med 1985;4:205-12.
Tiruneh TM, Wilson IB. What time is it? Adherence to antiretroviral therapy in Ethiopia. AIDS Behav 2016;20: 2662-2673
Schönnesson LN, Williams ML, Ross MW, Bratt G, Keel B. Factors associated with suboptimal antiretroviral therapy adherence to dose, schedule and dietary instructions. AIDS Behav 2007;11: 175–183.
Gill JC, Sabin LL, Hamer DH, Xu K, Zhang J, Li T et al. Importance of dose timing in achieving undetectable viral loads. AIDS Behave 2010;14: 785-93.
Wiens MO, MacLeods S, Muslime V, Ssenyonga M, Kizza R, et al. Adherence to antiretroviral therapy in HIV positive adolescents in Uganda assessed by multiple methods: a prospective cohort study. Paediatr Drugs 2012;14: 331 – 335.
Melbourne K, Geletko S, Brown S, Willey C, Chase S, et al. Program and abstracts of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (San Diego). Washington, DC: American Society for Microbiology; 1998.; p. 420.
Hales G, Mitchell J, Smith DE, Kippex S. Validity of patient questioning versus pill count as an assessment of compliance. Program and abstracts of the 12th World AIDS Conference. Geneva: Marathon Multimedia 1998
Chesney MA. Factors Affecting Adherence to Antiretroviral Therapy. Clin Infect Dis 2000;30: S171 – S176.
William PL, Storm D, Montepiedra G, Nichols S, Kammerer B, Sirois PA, Farley J, Malee K. Predictors of Adherence to Antiretroviral Medications in Children and Adolescents with HIV infection. Pediatrics. 2006;118: e1745 – e1757.
Mukhtar – Yola M, Adeleke S, Gwarzo D, Ladan ZF. Preliminary investigation of adherence to antiretroviral therapy among children in Aminu Kano Teaching Hospital, Nigeria. Afr J AIDS Res 2008;5: 141 – 144.
Haberer JE, Kiwanuka J, Nansera D, Ragland K, Mellins C, et al. Multiple Measures Reveal Antiretroviral Successes and Challenges in HIV Infected Ugandan Children. PLoS ONE 2012;7: e36737.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 The Nigerian Health Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.