Evaluating adherence to highly active antiretroviral therapy with use of pill counts and viral load measurement in the drug resources enhancement against AIDS and malnutrition program in Mozambique

Massimo Magnano San Lio, Riccardo Carbini, Paola Germano, Giovanni Guidotti, Sandro Mancinelli, Noorjehan Abdul Magid, Pasquale Narciso, Leonardo Palombi, Elsa Renzi, Ines Zimba, Maria Cristina Marazzi

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Abstract

Background. Maintaining treatment adherence among the growing number of patients receiving antiretroviral treatment in Africa is a dramatic challenge. The objective of our study was to explore the results of a computerized pill count method and to test the validity, sensitivity, and specificity of this method with respect to viral load measurement in an African setting. Methods. We performed a prospective, observational study involving patients who received first-line highly active antiretroviral therapy in Mozambique from 1 April 2005 through 31 March 2006. Enrolled patients had received treatment for at least 3 months before the study. For defining treatment adherence levels, pill counts were used, and the results were analyzed with viral load measurements at the end of the observation period. Results. The study involved 531 participants. During the 12 months of observation, 137 patients left the program or discontinued first-line therapy. Of the remaining 394 patients, 284 (72.1%) had >95% treatment adherence; of those 284 patients, 274 (96.5%) had a final viral load 95% treatment adherence and the final viral load was closer than that between >90% treatment adherence and viral load. Conclusions. Treatment adherence >95% maximizes the results of the nonnucleoside reverse-transcriptase inhibitor-based regimen. The pill count method appears to be a reliable and economic tool for monitoring treatment adherence in resource-limited settings.

Original languageEnglish
Pages (from-to)1609-1616
Number of pages8
JournalClinical Infectious Diseases
Volume46
Issue number10
DOIs
Publication statusPublished - May 15 2008

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ASJC Scopus subject areas

  • Immunology
  • Medicine(all)

Cite this

San Lio, M. M., Carbini, R., Germano, P., Guidotti, G., Mancinelli, S., Magid, N. A., Narciso, P., Palombi, L., Renzi, E., Zimba, I., & Marazzi, M. C. (2008). Evaluating adherence to highly active antiretroviral therapy with use of pill counts and viral load measurement in the drug resources enhancement against AIDS and malnutrition program in Mozambique. Clinical Infectious Diseases, 46(10), 1609-1616. https://doi.org/10.1086/587659