title: Clinical Utility of Pharmacy-Based Adherence Measurement in Predicting Virologic Outcomes in an Adult HIV-Infected Cohort in Jos, North Central Nigeria.
abstract: OBJECTIVE
  We examined the association between adherence to drug-refill visits and virologic outcomes in a cohort of HIV-infected adults on combination antiretroviral therapy (cART) in North Central Nigeria.
  
  
  METHODS
  Retrospectively, 588 HIV-infected, cART-naive adults (aged ≥15 years), initiated on first-line ART between 2009 and 2010 at the Jos University Teaching Hospital, were evaluated. Association between adherence to drug-refill visits, virologic (viral load>1000 copies/mL), and immunologic failure was assessed using multivariable logistic regression.
  
  
  RESULTS
  After a median of 12 months on cART, 16% (n=94) and 10% (n=59) of patients had virologic and immunologic failures, respectively. In the final multivariable model, suboptimal adherence to drug-refill visits was a significant predictor of both virologic (adjusted odds ratio [AOR] 1.6; 95% confidence interval [CI]:1.2-2.3) and immunologic (AOR 1.92; 95% CI:1.06-3.49) failures.
  
  
  CONCLUSIONS
  Adherence to drug refill is a useful predictor of successful virologic control and could be utilized for routine monitoring of adherence to cART in our clinical setting.
authors: Jos University Teaching Hospital, AIDS Prevention Initiative in Nigeria (APIN), Jos, Nigeria isaacabah@gmail.com.
authors: Isaac Okoh
authors: IO
authors: Abah
authors: Jos University Teaching Hospital, AIDS Prevention Initiative in Nigeria (APIN), Jos, Nigeria.
authors: Victor Bazim
authors: VB
authors: Ojeh
authors: University of Jos/Jos University Teaching Hospital, APIN Centre, Jos, Nigeria.
authors: Jonah
authors: J
authors: Musa
authors: Jos University Teaching Hospital, AIDS Prevention Initiative in Nigeria (APIN), Jos, Nigeria.
authors: Placid
authors: P
authors: Ugoagwu
authors: University of Jos/Jos University Teaching Hospital, APIN Centre, Jos, Nigeria.
authors: Patricia Aladi
authors: PA
authors: Agaba
authors: University of Jos/Jos University Teaching Hospital, APIN Centre, Jos, Nigeria.
authors: Oche
authors: O
authors: Agbaji
authors: AIDS Prevention Initiative in Nigeria Lte, Abuja, Nigeria.
authors: Prosper
authors: P
authors: Okonkwo
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009549:Nigeria; D010604:Pharmacy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019562:Viral Load / Q000187:drug effects; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; adherence; drug refill; pharmacy; virologic outcome