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Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy

The management of patients failing second line antiretroviral therapy (ART) is a critical area of study considering the increasing numbers of patients on second line regimens, and the expense and poor availability of third line ART. Most patients who experience virologic failure (VF) on second line...

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Main Author: Court, Richard Gray
Other Authors: Maartens, Gary
Format: Thesis
Language:English
Published: Department of Medicine 2015
Subjects:
Medicine
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access_status_str Open Access
author Court, Richard Gray
author2 Maartens, Gary
author_browse Court, Richard Gray
Maartens, Gary
author_facet Maartens, Gary
Court, Richard Gray
author_sort Court, Richard Gray
collection Thesis
description The management of patients failing second line antiretroviral therapy (ART) is a critical area of study considering the increasing numbers of patients on second line regimens, and the expense and poor availability of third line ART. Most patients who experience virologic failure (VF) on second line ART in low-middle income countries fail due to poor adherence rather than antiretroviral resistance. Pharmacy refill is an easily implementable adherence measure which has shown to correlate with viral load monitoring and survival, and has potential over the short term to be used as a simple adherence tool to detect probable VF on second line ART. The benefit would be conservation of resources by rationally limiting need for viral load (VL) testing and, in those countries with access to third line ART, the need for resistance testing. We conducted an observational cohort study of patients who initiated second line ART at the McCord hospital ART clinic, “Sinikithemba†in Kwazulu-Natal, South Africa. Using clinical and pharmacy refill data extracted from the clinic’s electronic database, we determined risk factors for VF. Three different methods of calculating short term pharmacy refill adherence were evaluated and compared with long term adherence after second line initiation. Different interval durations of short term pharmacy refill were also assessed to determine the optimum time period of pharmacy refill that correlates best with a virologic response on second line ART.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:34:10.861Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2015
publishDateRange 2015
publishDateSort 2015
publisher Department of Medicine
publisherStr Department of Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/13801 Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy Court, Richard Gray Maartens, Gary Medicine The management of patients failing second line antiretroviral therapy (ART) is a critical area of study considering the increasing numbers of patients on second line regimens, and the expense and poor availability of third line ART. Most patients who experience virologic failure (VF) on second line ART in low-middle income countries fail due to poor adherence rather than antiretroviral resistance. Pharmacy refill is an easily implementable adherence measure which has shown to correlate with viral load monitoring and survival, and has potential over the short term to be used as a simple adherence tool to detect probable VF on second line ART. The benefit would be conservation of resources by rationally limiting need for viral load (VL) testing and, in those countries with access to third line ART, the need for resistance testing. We conducted an observational cohort study of patients who initiated second line ART at the McCord hospital ART clinic, “Sinikithemba†in Kwazulu-Natal, South Africa. Using clinical and pharmacy refill data extracted from the clinic’s electronic database, we determined risk factors for VF. Three different methods of calculating short term pharmacy refill adherence were evaluated and compared with long term adherence after second line initiation. Different interval durations of short term pharmacy refill were also assessed to determine the optimum time period of pharmacy refill that correlates best with a virologic response on second line ART. 2015-08-27T12:35:09Z 2015-08-27T12:35:09Z 2015 Master Thesis Masters MMed http://hdl.handle.net/11427/13801 eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Medicine
Court, Richard Gray
Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy
thesis_degree_str Master's
title Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy
title_full Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy
title_fullStr Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy
title_full_unstemmed Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy
title_short Short term adherence tool predicts failure on second line protease inhibitor-based antiretroviral therapy
title_sort short term adherence tool predicts failure on second line protease inhibitor based antiretroviral therapy
topic Medicine
url http://hdl.handle.net/11427/13801
work_keys_str_mv AT courtrichardgray shorttermadherencetoolpredictsfailureonsecondlineproteaseinhibitorbasedantiretroviraltherapy

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