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Adolescents Adherence to HIV Regimens Falls Short of Optimal: Presented at CROI

By Ed Susman

DENVER, CO -- February 7, 2006 -- Doctors tracking the adherence to highly active antiretroviral therapy (HAART) among adolescents starting these regimens have less than optimal virologic responses.

Bret Rudy, MD, Associate Professor of Pediatrics, University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, discussed these findings here inn poster presentation on February 6^th at the 13^th Conference on Retroviruses and Opportunistic Infections (CROI).

After 3 years of therapy, only 24% of the adolescents in his study had undetectable blood levels of virus, Dr. Rudy said.

The study -- Pediatric AIDS Clinical Trials Group Protocol 381 -- was designed to evaluate the virologic and immunologic responses to HAART in adolescents who were infected through high-risk behavior. The adolescents in the group were not infected in utero, or through breastfeeding or blood transfusions.

After the first 6 months on treatment, about 58% of the 120 patients in Protocol 381 had achieved an undetectable HIV viral load using the 400-copy/mL assay. After 60 weeks, it was 47% and by 156 weeks, 24% still had undetectable viral loads.

At 3 years, 41 of the patients were still on their original therapy.

Dr. Rudy noted it might be possible to predict which of these patients was likely to remain faithful to the prescribed regimen -- either an efavirenz or a nelfinavir-based regimen with a zidovudine plus lamivudine backbone.

"Adherence during the first 16 weeks after starting therapy was an important predictor of short-term virologic response," he said. Patients who had not missed any doses in the first weeks of their treatment had a 65% greater chance of undetectable viral loads through week 24. He said that difference was statistically significant at the P = .032 level.


[Presentation title: Virologic and Immunologic Outcomes and Adherence in Adolescents initiating HAART: Three Year Follow-up data from PACTG 381. Abstract 684]

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