Factors predicting detectable viral load in patients with highly active antiretroviral treatment

• Published in: Medicina clínica Vol. 123; no. 2; p. 45
• Main Authors: Ortega, Luis, Cuevas, María José, Pérez-Simón, Rosario, Villares, Carmen, Alcoba, Manuel, Martín, Vicente
• Format: Journal Article
• Language: Spanish
• Published: Spain 12.06.2004
• Subjects: Adolescent; Adult; Aged; Antiretroviral Therapy, Highly Active; Cross-Sectional Studies; Female; HIV Infections - drug therapy; HIV Infections - virology; Humans; Male; Middle Aged; Models, Theoretical; Patient Compliance; Viral Load
• ISSN: 0025-7753
• DOI: 10.1157/13063174

Knowledge of the variables predicting detectable viral load in patients with highly active antiretroviral treatment. Observational and cross-sectional study in patients with antiretroviral treatment receiving two nucleoside reverse transcriptase inhibitors and one protease inhibitor. Several sociodemographic and clinic variables were registered. Two models were designed in order to assess the adherence: I. combining self-report and pharmacy criteria, and II. including drug plasma levels in adherent patients with the two former criteria and detectable viral load. Logistic regression analysis with variables found to be associated with detectable viral load in the univariate analysis, diagnostic algorithm and ROC statistics were performed in order to select the best model to predict detectable viral load. Among of 136 patients studied, 39 (28.7%) had detectable viral load. Patients less than 35 years old (OR = 2.68), intravenous drug users or heterosexual contacts as the way of HIV infection (OR = 6.42), patients not fully convinced of the capacity of mutation of the HIV by poor adherence (OR = 3.25) and patients considered non-adherent according to the drug plasma levels criteria (OR = 6.91) had more frequently detectable viral load. The best model to predict detectable viral load would include patients considered non-adherent according to the two models used, and moreover, patients where another of the factors of risk were detected; the prevalence of detectable viral load in these was of 10% versus 43%. Adherence to HAART is a key factor to predict detectable viral load, specially in young patients, infected by intravenous drug use or heterosexual contacts, and patients not convinced of the importance of the adherence.