title: Impact of HCV treatment and depressive symptoms on adherence to HAART among HIV-HCV-coinfected patients: results from the ANRS-CO13-HEPAVIH cohort.
abstract: BACKGROUND
  The additional burden of HCV infection in HIV-HCV-coinfected individuals may have some consequences on adherence to HAART. Few studies have explored the pattern of correlates of non-adherence to HAART while simultaneously considering the impact of HCV treatment and depressive symptoms on adherence to HAART. We used longitudinal data to assess factors associated with non-adherence to HAART.
  
  
  METHODS
  The French national prospective cohort ANRS-CO13-HEPAVIH is a multicentrer cohort, which recruited 1,175 HIV-HCV-coinfected patients in 17 hospital outpatient units delivering HIV and HCV care in France between October 2006 and June 2008. For this analysis, we selected participants on HAART with self-reported data for adherence to HAART (n=727 patients, 1,190 visits). Data were collected using self-administered questionnaires and medical records. A mixed logistic regression model based on an exchangeable correlation matrix was used to identify factors associated with non-adherence to HAART.
  
  
  RESULTS
  Patients reported non-adherence to HAART in 808 (68%) of the 1,190 visits. Four variables remained associated with non-adherence to HAART after multivariate analysis: hazardous alcohol consumption, cocaine use and depressive symptoms, regardless of whether treatment for depression was being received. Finally, patients being treated for HCV infection were less likely to be non-adherent to HAART.
  
  
  CONCLUSIONS
  Besides the problem of polydrug use, two other dimensions deserve special attention when considering adherence to HAART in HIV-HCV-coinfected patients. Access to HCV treatment should be encouraged as well adequate treatment for depression in this population to improve adherence and response to HAART.
authors.affiliation: INSERM UMR912 (SESSTIM), Marseille, France. perrine.roux@inserm.fr.
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.forename: Caroline
authors.initials: C
authors.lastname: Lions
authors.forename: Julien
authors.initials: J
authors.lastname: Cohen
authors.forename: Maria
authors.initials: M
authors.lastname: Winnock
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon-Céron
authors.forename: Firouze
authors.initials: F
authors.lastname: Bani-Sadr
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003625:Data Collection; D003863:Depression / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D000998:Antiviral Agents