Compliance with antiretroviral regimens to prevent perinatal HIV-1 transmission in Kenya
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Date
2012-06Author
Kiarie, James N.
Kreiss, Joan K.
Richardson, Barbra A.
Stewart, Grace C.John
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Objective: To compare compliance and infant HIV-1 infection risk at 6 weeks with
theThai-CDCandHIVNET-012antiretroviralregimensinafieldsetting.
Design: Randomizedclinicaltrial.
Setting: TertiaryhospitalantenatalclinicinNairobi,Kenya.
Participants: HIV-1infectedwomenreferredfromprimarycareclinics.
Interventions: Thai-CDCzidovudineregimenorHIVNET-012nevirapineregimen.
Main outcome measures: Women were considered compliant if they used>80% of
thedoses.InfantsweretestedforHIV-1at6weeks.
Results: Seventy women were randomized to Thai-CDC and 69 to HIVNET-012
regimens.Morewomenwerecompliantwiththeantenatal(86%)thantheintrapartum
(44%) Thai-CDC regimen doses (P¼0.001). Ninety-seven per cent took the maternal
and 91% gave the infant dose of the HIVNET-012 regimen (P¼0.2). Overall, 41%
were compliant with the Thai-CDC regimen and 87% with the HIVNET-012 regimen
(P,0.001). Compliance with the Thai-CDC regimen was associated with partner
support of antiretroviral use [odds ratio (OR), 3.0;, 95% confidence interval (CI), 1.0–
9.1] and knowledge at recruitment that antiretroviral drugs could prevent infant HIV-1
(OR, 2.9; 95% CI, 1.0–8.1). Compliance with the HIVNET-012 regimen was associated
with partner notification (OR, 8.0; 95% CI, 1.5–50) and partner willingness to
have HIV-1 testing(OR, 7.5; 95% CI, 1.4–40). There was a trend for a higher risk of
transmission with the HIVNET-012 regimen than with the Thai-CDC regimen (22%
versus9%;P¼0.07).
Conclusion: Compliance with the Thai-CDC and HIVNET-012 regimens was comparable
to that in efficacy trials. Partner involvement, support and education on perinatal
HIV-1 prevention may improve compliance and increase the number of infants
protectedfromHIV-1infection.
URI
http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/10256http://www.ncbi.nlm.nih.gov/pubmed/12478070
Citation
AIDS 2003,17:65-71Publisher
Obstetrics and Gynecology University of Nairobi
Subject
anti retroviral therapyvertical transmission
compliance
prevention of perinatal transmission
Collections
- Faculty of Health Sciences (FHS) [10387]