title: Nonadherence increases the risk of hospitalization among HIV-infected antiretroviral naive patients started on HAART.
abstract: BACKGROUND
  Since the advent of highly active antiretroviral therapy (HAART), AIDS-related hospitalizations have decreased. The objective of this study was to assess the impact of adherence on hospitalization among antiretroviral-naïve HIV-infected persons initiating HAART.
  
  
  METHODS
  Analysis was based on a cohort of individuals initiating HAART between 1996 and 2001. The primary outcome was hospitalization for one or more days. Survival methods were used to assess the impact of adherence on hospitalization.
  
  
  RESULTS
  Of 1605 eligible participants, 672 (42%) were hospitalized for one or more days after initiating HAART. Median adherence levels were 92 (IQR: 58, 100) and 100 (IQR: 83, 100) among those ever and never hospitalized, respectively. After controlling for confounders, those with <95% adherence had 1.88 times (95% CI: 1.60, 2.21) higher risk for hospitalization.
  
  
  CONCLUSIONS
  Suboptimal adherence among HIV-infected patients taking HAART predicts hospitalization. Identifying and addressing factors contributing to poor adherence early in treatment could improve patient care and lower hospitalization costs.
authors.affiliation: B.C. Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada, Department of Interdisciplinary Studies, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Fielden
authors.forename: Melanie L A
authors.initials: ML
authors.lastname: Rusch
authors.forename: Benita
authors.initials: B
authors.lastname: Yip
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
authors.forename: Adrian R
authors.initials: AR
authors.lastname: Levy
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality* / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012307:Risk Factors