New study adds to evidence showing adherence is linked to survival

Graham McKerrow, HIV i-Base

A new Spanish study published in the 1 May Journal of AIDS adds to the body of evidence linking adherence and survival. Barcelona researchers led by Patricia Garcia de Olalla found that the modifiable factors most strongly associated with survival were the type of treatment and adherence.

The cohort study looked at 1,219 patients over 18 years of age who began antiretroviral therapy (ART) between 1990 and 1999 at a single hospital in the city. Patients were considered non-adherent if the total dose of ARV drug was less than 90% of that prescribed.

In 23.7% of cases the first ART was with monotherapy, in 30.5% with two drugs and in 45.8% with three drugs. Multivariate analysis showed that the variables that presented significant differences with respect to mortality were clinical stage at beginning of treatment (relative hazard [RH] 2.97), CD4 cell count < 200 cells/mm3 (RH 5.89), type of treatment (monotherapy RH 9.76; bi-therapy 9.12) and nonadherence (RH 3.87).

The authors conclude: “The modifiable factors most strongly associated with survival were type of treatment and adherence. It would be desirable to accompany therapy with intervention strategies intended to improve adherence.”


Patricia García de Olalla; Hernando Knobel; Alexia Carmona et al. Impact of Adherence and Highly Active Antiretroviral Therapy on Survival in HIV-Infected Patients. JAIDS 2002;30:105-110.

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