HAART with didanosine once versus twice daily: adherence and efficacy.
BACKGROUND
Highly active antiretroviral therapy (HAART) containing didanosine taken twice daily was compared with HAART containing didanosine taken once daily in terms of adherence and efficacy.


METHODS
This was a self-controlled prospective cohort study, carried out in a tertiary level hospital. A total of 49 HIV-infected patients were included. They were prescribed HAART according to guidelines. After six months taking HAART containing didanosine twice daily, patients continued with the same regimen of HAART although once daily. Thereafter they were followed up for a further nine months. Adherence and virological efficacy were assessed at three-month intervals, for a total of six times, in every patient.


RESULTS
Overall, adherence was poor, with only 19 patients (39%) showing adequate adherence for all six visits. Adequate adherence was observed in 29 patients (59%) three months before didanosine switching, and in 37 patients (75%) three months after didanosine switching (P=0.034). Pooled HIV RNA results of the first three visits were higher than the same results of the last three visits (P=0.05).


CONCLUSIONS
Non-adherence is common among patients who take HAART. Simplification of regimens is useful to improve adherence and efficacy.
Roca
Bernardino
B
Infectious Disease Division, Hospital General of Castellón, Catalunya, 33-A, 4-12004 Castellón, Spain. brocav@meditex.es
Lapuebla
Consol
C
Vidal-Tegedor
Barbara
B
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D002626:Chemistry, Pharmaceutical; D015331:Cohort Studies; D016049:Didanosine / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies
D019380:Anti-HIV Agents; D016049:Didanosine