title: A Study of Compliance to Antiretroviral Therapy among HIV Infected Patients at a Tertiary Care Hospital in North Karnataka.
abstract: BACKGROUND
  Compliance to Antiretroviral Therapy (ART) is a primary determinant of treatment success of HIV-AIDS. Many studies have shown inadequate compliance to ART in the Indian population.
  
  
  OBJECTIVE
  To assess the compliance to ART among HIV infected patients, to explore the factors affecting compliance and impact of compliance on CD4 count.
  
  
  METHODS
  A cross-sectional study was conducted with 200 adult patients attending ART center, KIMS, Hubli. The patients were randomly selected and compliance to ART over preceding 3 months was assessed. Reasons for non- compliance were assessed among those with inadequate compliance.
  
  
  RESULTS
  Mean age of the study population was 40.07±9.99 years. The sex ratio was 1.02:1 (M:F). Majority of patients were in WHO stage 1 with treatment, with CD4 count above 500/μl. Pulmonary tuberculosis was the most common opportunistic infection. Most of the patients were on long term ART, more than 5 years {81 (40.5%)}. Most of the patients were on ZLN regimen {97 (48.5%)}. Compliance over the preceding 3 months was 94.84± 14.93% for ART and 88.97±23.75% for opportunistic infection prophylaxis. There was no significant difference in compliance in relation to age group, sex, educational status, residence, religion, habits, HIV status of spouse or child, the regimen of ART and frequency of dosing. The compliance was better among those on long term treatment, i.e., those on treatment for more than 5 years compared to those who started ART in last 1 year (p=0.06). The most common reasons given by patients for non-compliance were going away from home, busy with other work and simply forgot. Better compliance was associated with higher CD4 count.
  
  
  CONCLUSIONS
  Compliance to ART was inadequate in the studied population, which is a major obstacle to success of ART.
authors.affiliation: Professor and Head of Department, Department of General Medicine, Karnataka Institute of Medical Sciences , Hubli, Karnataka, India .
authors.forename: Ishwar Siddappa
authors.initials: IS
authors.lastname: Hasabi
authors.affiliation: Post Graduate, Department of General Medicine, Karnataka Institute of Medical Sciences , Hubli, Karnataka, India .
authors.forename: Arun Beekanahalli
authors.initials: AB
authors.lastname: Shivashankarappa
authors.affiliation: Assistant Professor, Department of General Medicine, Karnataka Institute of Medical Sciences , Hubli, Karnataka, India .
authors.forename: Chandrashekar
authors.initials: C
authors.lastname: Kachapur
authors.affiliation: Assistant Professor, Department of General Medicine, Karnataka Institute of Medical Sciences , Hubli, Karnataka, India .
authors.forename: Ram Suresh
authors.initials: RS
authors.lastname: Kaulgud
keywords: CD4 count; Compliance to medication; HIV-AIDS