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Adherence to Antiretroviral Therapy and Acceptability of Planned Treatment Interruptions in HIV-Infected Children |
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| Authors: | Linda Harrison Jintanat Ananworanich Djamel Hamadache Alexandra Compagnucci Martina Penazzato Torsak Bunupuradah Antonio Mazza Jose Tomas Ramos Jacquie Flynn Osvalda Rampon Maria Jose Mellado Pena Daniel Floret Magdalena Marczynska Ana Puga Silvia Forcat Yoann Riault Marc Lallemant Hannah Castro Diana M. Gibb Carlo Giaquinto |
| Affiliation: | 1. Medical Research Council Clinical Trials Unit, Aviation House, 125 Kingsway, London, WC2B 6NH, UK 2. HIV-NAT, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand 3. Imperial College Healthcare NHS Trust, London, UK 4. INSERM SC10, Paris, France 5. Department of Paediatrics, University of Padova, Padua, Italy 6. Ospedale S. Chiara, Trento, Italy 7. Hospital Universitario de Getafe, Madrid, Spain 8. Great Ormond Street Hospital for Children NHS Trust, London, UK 9. Instituto de Salud Carlos III, Madrid, Spain 10. H?pital Femme-Mère-Enfant, Lyon, France 11. Medical University of Warsaw, Warsaw, Poland 12. Childrens Diagnostic and Treatment Center, Fort Lauderdale, USA 13. Institut de Recherche pour le Développement (IRD), Chiang Mai University, Chiang Mai, Thailand |
| Abstract: | There have been no paediatric randomised trials describing the effect of planned treatment interruptions (PTIs) of antiretroviral therapy (ART) on adherence, or evaluating acceptability of such a strategy. In PENTA 11, HIV-infected children were randomised to CD4-guided PTIs (n = 53) or continuous therapy (CT, n = 56). Carers, and children if appropriate, completed questionnaires on adherence to ART and acceptability of PTIs. There was no difference in reported adherence on ART between CT and PTI groups; non-adherence (reporting missed doses over the last 3 days or marking <100 % adherence since the last clinical visit on a visual analogue scale) was 18 % (20/111) and 14 % (12/83) on carer questionnaires in the CT and PTI groups respectively (odds ratios, OR (95 % CI) = 1.04 (0.20, 5.41), χ2 (1) = 0.003, p = 0.96). Carers in Europe/USA reported non-adherence more often (31/121, 26 %) than in Thailand (1/73, 1 %; OR (95 % CI) = 54.65 (3.68, 810.55), χ2 (1) = 8.45, p = 0.004). The majority of families indicated they were happy to have further PTIs (carer: 23/36, 64 %; children: 8/13, 62 %), however many reported more clinic visits during PTI were a problem (carer: 15/36, 42 %; children: 6/12, 50 %). |
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