Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study

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dc.contributor.authorPhillips, Tamsinen_ZA
dc.contributor.authorCois, Annibaleen_ZA
dc.contributor.authorRemien, Robert Hen_ZA
dc.contributor.authorMellins, Claude Aen_ZA
dc.contributor.authorMcIntyre, James Aen_ZA
dc.contributor.authorPetro, Gregen_ZA
dc.contributor.authorAbrams, Elaine Jen_ZA
dc.contributor.authorMyer, Landonen_ZA
dc.date.accessioned2016-10-31T07:38:02Z
dc.date.available2016-10-31T07:38:02Z
dc.date.issued2016en_ZA
dc.description.abstractBACKGROUND: Antiretroviral therapy (ART) regimens containing efavirenz (EFV) are recommended as part of universal ART for pregnant and breastfeeding women. EFV may have appreciable side effects (SE), and ART adherence in pregnancy is a major concern, but little is known about ART SE and associations with adherence in pregnancy. METHODS: We investigated the distribution of patient-reported SE (based on Division of AIDS categories) and the association of SE with missed ART doses in a cohort of 517 women starting EFV+3TC/FTC+TDF during pregnancy. In analysis, SE were considered in terms of their overall frequency, by systems category, and by latent classes. RESULTS: Overall 97% of women reported experiencing at least one SE after ART initiation, with 48% experiencing more than five SE. Gastrointestinal, central nervous system, systemic and skin SE were reported by 81%, 85%, 79% and 31% of women, respectively, with considerable overlap across groups. At least one missed dose was reported by 32% of women. In multivariable models, ART non-adherence was associated with systemic SE compared to other systems categories, and measures of the overall burden of SE experienced were most strongly associated with missed ART doses. CONCLUSION: These data demonstrate very high levels of SE in pregnant women initiating EFV-based ART and a strong association between SE burden and ART adherence. ART regimens with reduced SE profiles may enhance adherence, and as countries expand universal ART for all adult patients, counseling must include preparation for ART SE.en_ZA
dc.identifier.apacitationPhillips, T., Cois, A., Remien, R. H., Mellins, C. A., McIntyre, J. A., Petro, G., ... Myer, L. (2016). Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study. <i>PLoS One</i>, http://hdl.handle.net/11427/22352en_ZA
dc.identifier.chicagocitationPhillips, Tamsin, Annibale Cois, Robert H Remien, Claude A Mellins, James A McIntyre, Greg Petro, Elaine J Abrams, and Landon Myer "Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study." <i>PLoS One</i> (2016) http://hdl.handle.net/11427/22352en_ZA
dc.identifier.citationPhillips, T., Cois, A., Remien, R. H., Mellins, C. A., McIntyre, J. A., Petro, G., ... & Myer, L. (2016). Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study. PloS one, 11(10), e0163079. doi:10.1371/journal.pone.0163079en_ZA
dc.identifier.ris TY - Journal Article AU - Phillips, Tamsin AU - Cois, Annibale AU - Remien, Robert H AU - Mellins, Claude A AU - McIntyre, James A AU - Petro, Greg AU - Abrams, Elaine J AU - Myer, Landon AB - BACKGROUND: Antiretroviral therapy (ART) regimens containing efavirenz (EFV) are recommended as part of universal ART for pregnant and breastfeeding women. EFV may have appreciable side effects (SE), and ART adherence in pregnancy is a major concern, but little is known about ART SE and associations with adherence in pregnancy. METHODS: We investigated the distribution of patient-reported SE (based on Division of AIDS categories) and the association of SE with missed ART doses in a cohort of 517 women starting EFV+3TC/FTC+TDF during pregnancy. In analysis, SE were considered in terms of their overall frequency, by systems category, and by latent classes. RESULTS: Overall 97% of women reported experiencing at least one SE after ART initiation, with 48% experiencing more than five SE. Gastrointestinal, central nervous system, systemic and skin SE were reported by 81%, 85%, 79% and 31% of women, respectively, with considerable overlap across groups. At least one missed dose was reported by 32% of women. In multivariable models, ART non-adherence was associated with systemic SE compared to other systems categories, and measures of the overall burden of SE experienced were most strongly associated with missed ART doses. CONCLUSION: These data demonstrate very high levels of SE in pregnant women initiating EFV-based ART and a strong association between SE burden and ART adherence. ART regimens with reduced SE profiles may enhance adherence, and as countries expand universal ART for all adult patients, counseling must include preparation for ART SE. DA - 2016 DB - OpenUCT DO - 10.1371/journal.pone.0163079 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 T1 - Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study TI - Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study UR - http://hdl.handle.net/11427/22352 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0163079en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/22352
dc.identifier.vancouvercitationPhillips T, Cois A, Remien RH, Mellins CA, McIntyre JA, Petro G, et al. Self-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective study. PLoS One. 2016; http://hdl.handle.net/11427/22352.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2016 Phillips et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherAntiretroviral therapyen_ZA
dc.subject.otherPregnancyen_ZA
dc.subject.otherCentral nervous systemen_ZA
dc.subject.otherAntenatal careen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherDose prediction methodsen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherHIV diagnosis and managementen_ZA
dc.titleSelf-reported side effects and adherence to antiretroviral therapy in HIV-infected pregnant women under option B+: a prospective studyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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