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AIDS Research and Treatment
Volume 2010 (2010), Article ID 142076, 6 pages
http://dx.doi.org/10.1155/2010/142076
Research Article

Simplified Assessment of Antiretroviral Adherence and Prediction of Virological Efficacy in HIV-Infected Patients in Cambodia

1Service de Médecine Interne, Centre Hospitalier Universitaire de Bicêtre, AP-HP, 94270 Le Kremlin Bicêtre, France
2Unité d'Epidémiologie des maladies émergentes, Institut Pasteur, 75015 Paris, France
3Service de Maladies Infectieuses, Hôpital Calmette, 12100 Phnom-Penh, Cambodia
4Service de Pharmacologie, Centre Hospitalier Universitaire de Bicêtre, AP-HP, 94270 Le Kremlin Bicêtre, France
5Laboratoire VIH/Hépatites, Institut Pasteur, 12100 Phnom-Penh, Cambodia

Received 18 August 2009; Accepted 24 November 2009

Academic Editor: Patrice K. Nicholas

Copyright © 2010 Olivier Segeral et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Adherence to antiviral therapy is important for HIV-infected people living in low- and middle-income countries, because of poor access to alternative regimens. Methods. We conducted a cross-sectional survey of adherence in Cambodian patients enrolled in the ESTHER program and treated with WHO first-line regimen for at least 6 months. The survey was based on a self-report questionnaire, drug assay, MCV measurement, visual analog scale, and viral load HIV RNA. Results. Two hundred fifty-nine patients treated for a median of 16 months participated in the survey. At inclusion in the program, 158 patients (61%) were ARV-naïve. The virological success rate was 71% overall and 81% in previously ARV-naive patients. Considered individually, the measures suggested perfect adherence in 71% to 93% of patients. In multivariate analysis adjusted for sex and therapeutic status before HAART initiation, only the biological markers were associated with virological efficacy. Self-funded treatment before entry to the program was highly predictive of virological failure. Conclusion. Adherence was excellent in these Cambodian patients. Biological markers were predictive of virological efficacy. MCV might thus serve as a simple alternative for assessing adherence and predicting virological efficacy among patients receiving AZT- or d4T-based regimens.