Appiah, LT

Beloukas, A

Chadwick, D

Geretti, AM

Phillips, RO

Ruggiero, A

Sarfo, FS

Smith, C

Stockdale, A

Villa, G

University of Liverpool Repository

Volume 19, Supplement 7 October 2016Abstract supplementInternational Congress of Drug Therapy in HIV Infection23-26 October 2016, Glasgow, UKScan this QR code with  your mobile device to view  the supplement onlineJoint Academic SponsorsUniversity CollegeLondon Medical School(UCLMS), UKWeill Cornell Medicine New York, USAInternational AIDS SocietyAcademic Medical CentreUniversity of AmsterdamThe NetherlandsCHALLENGING CASES IN HIVTHE WAY  FORWARDTREATMENT STRATEGIESANTIRETROVIRALS: PROGRESSCO-INFECTIONS AND MALIGNANCIESCO-MORBIDITIESAND HIV MANAGEMENTKEEPING THE PATIENT IN THE CENTRE OF QUALITY CAREDRUG-DRUG INTERACTIONSPREP IN H I G H INCOME SETTINGSPHARMACOKINETICSAND DRUG INTERACTIONSANTIRETROVIRAL STRATEGIES AND NEW DRUGSCRITICALISSUES INEASTERNANDCENTRALE U RO P EAGEING AND CANCERAPPS ANDNEW TECHNOLOGIESConclusions: Real-life outcomes of PI-based dual ARV therapy appearbroadly favourable in clinical practice. The ongoing utility of thisparadigm in the advent of TAF and PI-sparing regimens is unclear.P059Long-term virological outcomes of replacing zidovudine orstavudine with tenofovir in the absence of routinevirological monitoring in Kumasi, GhanaGiovanni Villa1; Richard Odame Phillips2; Colette Smith3;Alexander Stockdale1; Apostolos Beloukas1; Lambert Tetteh Appiah4;David Chadwick5; Alessandra Ruggiero1; Fred Stephen Sarfo2 andAnna Maria Geretti11Institute of Infection and Global Health, University of Liverpool,Liverpool, UK. 2Department of Medicine, Kwame Nkrumah Universityof Science and Technology and Komfo Anokye Teaching Hospital,Kumasi, Ghana. 3Infection and Population Health, University CollegeLondon, London, UK. 4Department of Medicine, Komfo AnokyeTeaching Hospital, Kumasi, Ghana. 5Centre for Clinical Infection,James Cook University Hospital, Middlesbrough, UKIntroduction: Whilst access to ART is successfully expanding in Africa,long-term outcomes remain poorly investigated. This study ad-dressed the outcomes of introducing tenofovir (TDF) in place ofzidovudine (ZDV) or stavudine (d4T) among Ghanaian adultsreceiving HIV care in the absence of routine virological monitoringand determined the associated clinical and psychosocial dimensions.Methods: The Hepatitis B Infection in Kumasi (HEPIK) study hasprospectively followed HIV/HBV co-infected adults since 2010. Thiscross-sectional analysis comprised subjects that had previouslystarted ZDV or d4T plus lamivudine and efavirenz or nevirapine,and at the time of HBV diagnosis (T0), replaced ZDV or d4T with TDFin the absence of virological monitoring. A median of 7.9 (IQR 6.09.2) years after starting ART and 4.0 (3.84.1) years after introducingTDF (T1, November 2015), patients were invited to attend forassessment, including HIV-1 RNA load, and offered a researcher-administered questionnaire about adherence (visual analogue scaleand targeted questions); socio-economic, social support and dis-closure status; and physical and mental health. Plasma viral load atT0 was determined retrospectively using stored (808C) samples.Results: A total of 101/180 (56%) invited participants (66% females)attended the T1 assessment. Of the remaining, 47 (26%) were nolonger contactable (]3 attempts), 17 (9%) declined to attend and 15(8%) had died. At T1, mean age was 45 (99) years; 90% were stillreceiving efavirenz (n87) or nevirapine (n4); 10% were onlopinavir/ritonavir (LPV/r). CD4 counts were median 572 (383716)cells/mm3. Suboptimal adherence was reported by 42% of partici-pants; in univariable analysis, it was more prevalent among men(pB0.01), those in a relationship (p0.02) and those with highersocio-economic status (p0.04). Moderate-to-severe depression/anxiety was reported by 27%; 64% described moderate-to-severephysical distress. HIV-1 RNA was detectable (40 copies/mL) in21%, and 1000 copies/mL in 14%, with median levels of 4.2 (2.15.1) log10 copies/mL. In univariable analysis, predictors of lack ofvirological suppression comprised the CD4 cell count at diagnosis(p0.03), T0 viral load (p0.05), suboptimal adherence (pB0.01),lack of partner disclosure (pB0.01) and LPV/r use (p0.03). Lack ofvirological suppression was also associated with lower T1 CD4 cellcounts (pB0.01). There was no association with socio-economic/social support status, or physical/mental health.Conclusion: One in five subjects receiving long-term ART showedsuboptimal virological suppression with reduced CD4 cell countrecovery. The findings highlight the importance of viral load testing atkey management time points, coupled with targeted interventions tosupport adherence and facilitate partner disclosure.P060Non-adherence in HIV patients is caused by specificreasons: results from the German adherence cohort studyJohanna Boretzki1; Carmen Wiese2; Celia Oldenbuettel2;Ivanka Krznaric3; Anja Meurer4; Alexander Zink5; Christian Lersch1;Annamaria Balogh6; Eva Wolf6 and Christoph Spinner11Department of Medicine II, University Hospital Klinikum rechts derIsar, Munich, Germany. 2Private Practice, MVZ Karlsplatz, Munich,Germany. 3Private Practice, Zentrum fu¨r Infektiologie Berlin, Berlin,Germany. 4Private Practice, Zentrum fuer Innere Medizin undInfektiologie, Munich, Germany. 5Department of Dermatology andAllergology, University Hospital Klinikum rechts der Isar, Munich,Germany. 6MUC Research, Munich, GermanyIntroduction: Adherence to antiretroviral treatment (ART) in HIVpatients plays a crucial role for treatment success. Our study aimedto identify reasons for non-adherence in a large HIV cohort, includingknown subjects with difficulties in ART adherence.Methods: A cross-sectional, non-interventional, multicentre adher-ence study in treated HIV-infected patients from September 2014 toApril 2015 in Germany was performed after ethic committee’sapproval. Study physicians were asked to recruit patients from alladherence levels and perform an adherence assessment for eachsubject (good, unstable or poor adherence). Questionnaires based onthe SMAQ-MASRI-Hybrid [1] were given to the patient and treatingphysician to evaluate factors associated with poor adherence.Covariables of interest were age, sex, time since HIV diagnosis,time on ART, current ART regimen, transmission route, comorbidity,HIV-1 RNA viral loads (VLs) and CD4 cell count. Furthermore, specificreasons for non-adherence were assessed. For statistical analysis,extended Fisher’s exact test and KruskalWallis test were used.Abstract P060Table 1. Overview of questionnaire items and correlation with adherence levels‘‘Good adherence’’(n162)‘‘Unstableadherence’’ (n36)‘‘Poor adherence’’(n17)p-value (Fisher’sexact test)The ART intake reminds me of my disease n7 (4.3%) n4 (11%) n5 (29%) B0.01I want to go out/I think my medication does not go wellwith alcohol/party drugsn3 (1.9%) n5 (14%) n4 (24%) B0.01I’m afraid that others see me taking the ARTmedication n4 (2.5%) n4 (11%) n2 (12%) 0.019I think that the ART dose is too high n3 (1.9%) n4 (11%) n1 (5.9%) 0.037Sometimes the copayment fee to my ART is too muchfor me/other financial reasonsn2 (1.2%) n3 (8.3%) n1 (5.9%) 0.037Abstracts of the HIV Glasgow supplementJournal of the International AIDS Society 2016, 19 (Suppl 7)http://www.jiasociety.org/index.php/jias/article/view/21487 | http://dx.doi.org/10.7448/IAS.19.8.21487 Poster Abstracts58

Long- term virological outcomes of replacing zidovudine or stavudine with tenofovir in the absence of routine virological monitoring in Kumasi, Ghana

Long- term virological outcomes of replacing zidovudine or stavudine with tenofovir in the absence of routine virological monitoring in Kumasi, Ghana

Abstract

Similar works

Full text

Available Versions

University of Liverpool Repository