Browsing by Author "Boakye, Dorothy Serwaa"

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    Adherence To Antiretroviral Therapy And Its Impact On Clinical And Immunologic Outcomes
    (2015-11-03) Boakye, Dorothy Serwaa
    Adherence to highly active antiretroviral therapy (HAART) has been associated with achieving success in virologic suppression, CD4 cell recovery, and improved patient well-being. Most of these researches reporting on the impact of adherence to HAART on treatment outcomes are published works from resource rich setting with little or no literature from Ghana. This study was therefore conducted to assess the impact of adherence to HAART on clinical and immunologic outcomes at two nationally designated HIV treatment centers in Kumasi, Ghana. The study was a prospective non- randomised study of HIV- infected patients at Aniwaa medical center and Bomso specialist hospital, private health facilities in the Kumasi metropolis. The patients were recruited to initiate antiretroviral therapy. A total of 86 patients were enrolled and 85 completed. Data collection lasted for 1 year 1 month. Patients were assessed for their level of adherence to HAART over a nine month period during interviews and pill counts. Patients who took ≥95% of their medication were classified as adherent whiles those who took ≤ 95% of their regimen were described as non- adherent. Data regarding clinical outcomes were collected at baseline, 3 month, 6 month and 9 th month, whereas data on immunologic outcomes were collected at baseline, 6 month and 9 month respectively. The data obtained was coded, entered into SPSS version 20.0 and analyzed. Over 90% of the participants were adherent to their therapy. Common reasons for missing medications were side effect (44.7%), forgetfulness (42.4%), being away from home (42.4%). The mean CD4 count at baseline was 235cells/uL, 6 th month (394cells/uL) and 9 th month (469cells/uL). Mean number of opportunistic infections and signs and symptoms was 3.34 and 4.79 at baseline, 1.56 and 2.03 at 3 rd month, v 1.12 and 1.16 at 6 th month and 1.00 and 1.13 at 9 th month. Overall physical health of patients improved from poor at baseline to good at the 9 th month. Adherence to HAART was a strong predictor of immune recovery, growth and clinical progression but adherence was seen not to be the only predictor of treatment outcomes. Baseline CD4 count was also found to predict outcomes for HIV infected patients. The most frequently used ARV in combination therapies was Tenofovir. Majority of patients in the study were adherent. After the nine months of study, both immunologic and clinical outcomes of patients significantly improved.