Prospective Cohort Study Among 160 HIV/AIDS Patients Who Accepted HAART In Nanning

Back ground:By September 30,2008,a total of 264,302 AIDS cases have been reported in China including 77,753 AIDS patients and 34,864 deaths.While the overall rate of AIDS incidences in China is still low,the epidemic is concentrated among specific populations and regions.Eighty percent of reported AIDS cases are accounted for by 6 provinces and autonomous regions.Among these high prevalent regions,Guangxi Province reports the third highest rate of AIDS cases.In order to improve the quality of the free antiretroviral treatment and related services for AIDS patients in China,the therapeutic efficacy of HAART for AIDS patients in different regions and their medication adherence is currently being explored in China.The purpose of this study is to understand the therapeutic efficacy of HAART in patients in Nanning,Guangxi Province and the patients' medication adherence to provide comparative data and a scientific basis for other regional researches in China.Object:The purpose of this study is to investigate the efficacy of a 6 month HAART treatment and factors that may influence treatment results in a prospective cohort study on HIV/AIDS patients in Nanning.In addition,this study will investigate the medication adherence of the patients in Nanning,reasons for noncompliance,and tools patients use to improve their medication adherence.Methods:A prospective cohort study was used.Study participants were selected from HIV/AIDS patients treated at the Guangxi Center of Disease Control and Prevention(CDC) and the Fourth People's Hospital in Nanning from 2007 to 2008.The selection of patients was in strict accordance with the selection and exclusion criteria.Two questionnaires were designed based on the goals of the project.Participants filled out a baseline questionnaire and then received HAAT treatment.At the end of a 6 month treatment period,patients participated in a follow-up investigation including a 6 month treatment questionnaire. Laboratory indicators of treatment efficacy included viral load(VL) and CD₄⁺ T lymphocyte count.Medication adherence was measured by self-reporting and pill counting.EpiData3.0 was used to establish a database and SPSS13.0 was used for the statistical analysis.Research design and data collection process was approved by the CDC Ethics Review Board(IRB).Result:In the six months of study,6 people died,6 withdrew and 1 was lost to follow-up.The anti-viral effect of the six month treatment was good,with a total treatment efficacy rate of 95.1%.CD₄⁺ T lymphocyte counts increased(x²=29.170,P=0.000) and the averageâ–³CD₄⁺ T lymphocyte count was 128 cell /ul.Good medication adherence appeared in 98.6%of patients.The degree of medication adherence did not significantly vary between calculations obtained through self-reporting and pills counting(P=1.000).Common self-reported causes of noncompliance included forgetting,too busy,not carrying medication when going out,and fear of drug side effects or adverse interactions with other drugs.There was one case that had special reasons for missing medication.Patients did not report psychological or physical burden of disease and lack of knowledge of HIV medication as common reasons for missing medication.Tools commonly used to improve medication adherence starting with most frequent included setting an alarm clock, reminders from others,using a wristwatch,placing medication in specific areas,and combining habit of taking medication with a daily routine.Conclusion:The result of a 6 month HAART treatment for the 160 HIV/AIDS patients of Nanning City in Guangxi was satisfying.Laboratory results of the therapy's anti-viral effect correlated with medication adherence results.The main factors causing patients to miss medication appeared to be forgetfulness,not having time,not carrying medications with them and fear of drug side effects or interactions with other drugs.Nonetheless,the majority of participants displayed good medication adherence.Common techniques employed to remind participants to take medication included setting alarm clocks, reminders from other people,and working medication into daily routines.Encouraging HIV/AIDS patients to utilize routines and tools that improve medication adherence would be a low cost method that would greatly improve the effectiveness of HAART.