Association of adherence to Mycobacterium avium complex prophylaxis and antiretroviral therapy with clinical outcomes in acquired immunodeficiency syndrome

Susan E. Cohn; Erin Kammann; Paige Williams; Judith S. Currier; Margaret A. Chesney

doi:10.1086/339542

Association of adherence to Mycobacterium avium complex prophylaxis and antiretroviral therapy with clinical outcomes in acquired immunodeficiency syndrome

Susan E. Cohn, Erin Kammann, Paige Williams, Judith S. Currier, Margaret A. Chesney

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

High-level adherence to regimens of combination antiretroviral therapy and prophylactic medications for opportunistic infections (OIs) is crucial to their success. However, little is known about the association between adherence to these life-sustaining therapies and such clinical outcomes as progression of acquired immune deficiency syndrome (AIDS) or development of OIs. We assessed adherence to regimens of antiretroviral and Mycobacterium avium complex (MAC) prophylactic medications in 643 patients enrolled in a trial of MAC prophylaxis. By week 56 of the study follow-up, 42% of the patients reported nonadherence to MAC prophylaxis, whereas one-quarter of the patients reported nonadherence to potent antiretroviral regimens. Nonadherence to both MAC prophylaxis and antiretroviral therapy was associated with higher human immunodeficiency virus (HIV) type 1 RNA levels and a significant increase in the risk of developing an AIDS-defining complication or death. Predictors of nonadherence are presented. These results underscore the clinical significance of adherence to HIV therapy and may be helpful in designing interventions to optimize the management of HIV by improving adherence.

Original language	English (US)
Pages (from-to)	1129-1136
Number of pages	8
Journal	Clinical Infectious Diseases
Volume	34
Issue number	8
DOIs	https://doi.org/10.1086/339542
State	Published - Apr 15 2002

Funding

Grant support: University of Rochester Medical Center, Adult AIDS Clinical Trials Unit (grant 5 UO1 AI-27658 to S.E.C.); National Institutes of Health (grant T32 ES07142-18 to E.K.); Statistical and Data Analysis Center (grant 2 U01 AI-38855 to P.W.); University of California, Los Angeles, Adult AIDS Clinical Trials Unit (grant AI-27660 to J.S.C.); University of California, San Francisco (UCSF) Center for AIDS Research (grant P30 MH59037 to M.A.C.); UCSF California AIDS Research Center (grant CC99-SF-00 to M.A.C.); and UCSF Adult AIDS Clinical Trials Unit (grant AI-27663 to M.A.C.).

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Association of adherence to Mycobacterium avium complex prophylaxis and antiretroviral therapy with clinical outcomes in acquired immunodeficiency syndrome",

abstract = "High-level adherence to regimens of combination antiretroviral therapy and prophylactic medications for opportunistic infections (OIs) is crucial to their success. However, little is known about the association between adherence to these life-sustaining therapies and such clinical outcomes as progression of acquired immune deficiency syndrome (AIDS) or development of OIs. We assessed adherence to regimens of antiretroviral and Mycobacterium avium complex (MAC) prophylactic medications in 643 patients enrolled in a trial of MAC prophylaxis. By week 56 of the study follow-up, 42% of the patients reported nonadherence to MAC prophylaxis, whereas one-quarter of the patients reported nonadherence to potent antiretroviral regimens. Nonadherence to both MAC prophylaxis and antiretroviral therapy was associated with higher human immunodeficiency virus (HIV) type 1 RNA levels and a significant increase in the risk of developing an AIDS-defining complication or death. Predictors of nonadherence are presented. These results underscore the clinical significance of adherence to HIV therapy and may be helpful in designing interventions to optimize the management of HIV by improving adherence.",

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note = "Funding Information: Grant support: University of Rochester Medical Center, Adult AIDS Clinical Trials Unit (grant 5 UO1 AI-27658 to S.E.C.); National Institutes of Health (grant T32 ES07142-18 to E.K.); Statistical and Data Analysis Center (grant 2 U01 AI-38855 to P.W.); University of California, Los Angeles, Adult AIDS Clinical Trials Unit (grant AI-27660 to J.S.C.); University of California, San Francisco (UCSF) Center for AIDS Research (grant P30 MH59037 to M.A.C.); UCSF California AIDS Research Center (grant CC99-SF-00 to M.A.C.); and UCSF Adult AIDS Clinical Trials Unit (grant AI-27663 to M.A.C.).",

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AU - Chesney, Margaret A.

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N2 - High-level adherence to regimens of combination antiretroviral therapy and prophylactic medications for opportunistic infections (OIs) is crucial to their success. However, little is known about the association between adherence to these life-sustaining therapies and such clinical outcomes as progression of acquired immune deficiency syndrome (AIDS) or development of OIs. We assessed adherence to regimens of antiretroviral and Mycobacterium avium complex (MAC) prophylactic medications in 643 patients enrolled in a trial of MAC prophylaxis. By week 56 of the study follow-up, 42% of the patients reported nonadherence to MAC prophylaxis, whereas one-quarter of the patients reported nonadherence to potent antiretroviral regimens. Nonadherence to both MAC prophylaxis and antiretroviral therapy was associated with higher human immunodeficiency virus (HIV) type 1 RNA levels and a significant increase in the risk of developing an AIDS-defining complication or death. Predictors of nonadherence are presented. These results underscore the clinical significance of adherence to HIV therapy and may be helpful in designing interventions to optimize the management of HIV by improving adherence.

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Association of adherence to Mycobacterium avium complex prophylaxis and antiretroviral therapy with clinical outcomes in acquired immunodeficiency syndrome

Abstract

Funding

ASJC Scopus subject areas

UN SDGs

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