Association Between Antiretroviral Therapy Adherence and Clinical Outcomes among Human Immunodeficiency Virus Patients at Medication Therapy Adherence Clinic

Abstract

Human Immunodeficiency virus (HIV) negatively impacts the immune system, particularly CD4 count, and causes acquired immune deficiency syndrome (AIDS)-related illnesses and death. Most HIV patients have a decrease in viral load (VL) at the start of antiretroviral therapy (ART), but recovery of CD4 count varies. The objective of the study is to determine the association between clinical outcomes among HIV patients and antiretroviral therapy adherence. A retrospective cross-sectional study was conducted at the infectious disease (ID) clinic. HIV patients started on antiretroviral therapy (ART) were recruited and followed up for a minimum of 6 months with at least one Malaysia Medication Adherence Assessment Tool (MyMAAT) done by pharmacist at Retroviral Disease Medication Therapy Adherence Clinic (RVD MTAC). Data were retrieved using a data collection form and analyzed using SPSS version 25. A total of 30 subjects were recruited with 93.3% of patients were categorized as good adherence (score > 54) based on MyMAAT. The median self-reported adherence score was 60 [IQR: 59-60]. The median pharmacy refill adherence rate was 100% [IQR: 99.9-100]. Using pharmacy refill adherence rate, patients were categorise using threshold of > 90%, 93.3% were adherent to ART. An exploratory analysis showed that, there were significant difference between the CD4 count pre and post ART among those with good adherence. There was significant difference between clinical outcome (baseline CD4 and CD4 post antiretroviral initiation) among HIV patients who were having good adherence towards antiretroviral therapy.