Adherence to prescribed medications is a significant component in the success of combination antiretroviral therapy (cART) for people living with human immunodeficiency virus (HIV) infection. As such, Awoke Seyoum Tegegne and colleagues conducted a study to compare adherence and CD4 cell count with virologic failure. They found that adherence, assessed via pill count, was a more accurate measure for assessing virologic responses compared to CD4 cell count.
Given this finding, Tegegne and the other authors recommended that adherence to cART be used to monitor the patients with HIV “because of its easy access, simple use, cost-effectiveness, and accuracy.” Their results were published in HIV/AIDS.
The investigators retrospectively enrolled 792 randomly selected adult patients with HIV who had initiated first-line cART in the first 10 months of 2012. The participants were then followed through to August 2018 using a “simple random sampling technique based on their identification number.” The primary outcome of interest was virologic failure.
According to the report, the area under the receiver operating characteristic (ROC) curve for adherence and CD4 cell count change were 0.68 and 0.63, respectively, at the 12-month assessment (χ2 = 21.2; p <0.001). The adherence and CD4 cell count ROC results were consistent throughout the study at 0.71 and 0.66 (χ2 = 23.2; p <0.001) and 0.73 and 0.71 (χ2 = 24.3; p < 0.001) at the 36- and 60-month assessments, respectively.
Overall, virologic failure decreased with successive visits, and the authors ultimately judged that the healthcare quality of patients living with HIV was better tracked via adherence to cART rather than by CD4 cell count. Their findings could improve the ability of providers to identify patients with poor adherence and thereby improve their chances of succeeding cART.