African patients and adherence in the UK

In order to assess whether there is any evidence to support the widely held view that Africans living in the UK are less likely to accept and adhere to HAART, a small retrospective study from Newham General Hospital evaluated adherence levels and virological response in African vs non-African patients.

The investigators performed a case note review of all HIV positive persons diagnosed between October 1998 and October 2001, allowing a minimum follow up period of 15 months. Pregnant women or those diagnosed through antenatal testing and people who were antiretroviral experienced were excluded from the analysis.

Of a total of 142 eligible patients, 117 were African and 25 non-African. African patients were more likely to be women compared to non-Africans (58% vs 28%). They were also more likely to present with a lower CD4 count (197 vs 245 cells/mm3).

The investigators reported no difference in achieving undetectable viral load results of <50 copies/mL (one or more measurement during the study period) – 83% in both groups. At six and 18 months the proportion of patients with an undetectable viral load was 76% and 59% for African and 67% and 44% for non-African. They also reported that despite lower initial CD4 counts, African patients achieved similar increases in CD4 counts over time.

The investigators concluded that this study suggests in this London clinic: “The uptake and adherence in African patients is similar to non-African patients.”

Wheeler H, Leventis P, Chilton D et al. Do African patients accept and adhere to HAART? 9th EACS, Warsaw. 25-29 October 2003. Abstract 10.1/9