title: Correlation of Adherence by Pill Count, Self-report, MEMS and Plasma Drug Levels to Treatment Response Among Women Receiving ARV Therapy for PMTCT in Kenya.
abstract: Success of antiretroviral therapy depends on adherence to effective treatment. We evaluated four adherence methods and their correlation with immunological and virologic response among women receiving PMTCT. Univariable and multivariable analyses were used to assess how adherence by pill count (n = 463), self-report (n = 463), MEMS (n = 129) and plasma drug level (n = 89) was associated with viral load suppression within a 6 months period. Longitudinal analysis was performed to determine the correlation of CD4 cell count with each measure of adherence. For all measures of adherence, sustained viral suppression was less likely for participants in the lowest category of adherence. Although CD4 cell count increased substantially over time, there was no significant association with adherence by the methods. Multiple strategies can be used successfully to monitor treatment adherence. Persons with ≥95% adherence by any method used in this study were more likely to have a favorable treatment outcome.
authors.affiliation: HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Victor
authors.identifier: 0000-0003-4841-4555
authors.initials: V
authors.lastname: Mudhune
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop G-45, Atlanta, GA, 30333, USA.
authors.forename: Roman
authors.initials: R
authors.lastname: Gvetadze
authors.affiliation: ICF International, Atlanta, GA, USA.
authors.forename: Sonali
authors.initials: S
authors.lastname: Girde
authors.affiliation: HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Richard
authors.initials: R
authors.lastname: Ndivo
authors.affiliation: HIV Research Branch, Kenya Medical Research Institute, Kisumu, Kenya.
authors.forename: Frank
authors.initials: F
authors.lastname: Angira
authors.affiliation: Centers for Disease Control and Prevention, HIV Research Branch, Kisumu, Kenya.
authors.forename: Clement
authors.initials: C
authors.lastname: Zeh
authors.affiliation: Centers for Disease Control and Prevention, HIV Research Branch, Kisumu, Kenya.
authors.forename: Timothy
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop G-45, Atlanta, GA, 30333, USA. gux5@cdc.gov.
authors.forename: Shirley Lee
authors.initials: SL
authors.lastname: Lecher
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya / Q000453:epidemiology; D055617:Micro-Electrical-Mechanical Systems; D057566:Self Report; D016896:Treatment Outcome; D019562:Viral Load; D016903:Drug Monitoring
keywords: Adherence; MEMS; Pill-count; Plasma drug; Self-report