Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

40 Abstracts WePeB5834-WePeB5837

XIV International AIDS Conference

Comprehensive adherence and counselling in coping with an HIV diagnosis was
given. Issues affecting adherence were recorded on a standardised proforma developed in our clinic.
Results: 35/43 patients chose to take therapy (28 combivir/nevirapine, 7
trizivir/efavirenz). Adherence was good. 30/35 scored highly on the adherence
proforma irrespective of symptoms at seroconversion or regimen chosen. This
was supported by the absence of de novo drug resistance on finishing therapy.
Individual reactions to their diagnosis and the degree of social support varied but
appeared to have no effect on whether or not they chose to be treated or their
adherence. 5/35 experienced toxicity requiring a change in their ART regimen. Of
these only 1 stopped altogether. All adjusted well to their HIV diagnosis. Many patients suggested that taking medication and more frequent clinic visits improved
their ability to cope.
Conclusions: Short course treatment of primary HIV infection is acceptable, well
tolerated and adherence is good. More detailed, ongoing studies are required to
identify the specific needs of PHI patients.
Presenting author: Zoe Sheppard, Wharfside clinic, St mary's hospital, Paddington, W2 1NY, United Kingdom, Tel.: [phone], Fax: [phone], E-mail:
zoe.sheppard @st-marys.nhs.uk
WePeB5834] Impact of a once-daily three-drug antiretroviral
regimen on the quality of life and adherence of
HIV-1+ patients with viral load suppression
C.R. Fumaz1, A. Tuldra1, M.J. Ferrer2, M. Barcel6b1, E. Negredo1, S. Gel1,
E.R. Arisa1, B. Clotet2. 1Fundacid Lluita Sida, Ctra. Canyet s/n 08916 Badalona,
Spain; 2Germans Trias i Pujol University Hospital, Badalona, Spain
Background: Once-daily antiretroviral regimens (QD) may favour patients' (pts)
adherence (ADH) to treatment and improve quality of life (QOL) and general satisfaction (GS).
Methods: Prospective study in which 30 pts with viral load suppression switched
their HAART to NVP+ddl+TDF taken once a day to simplify therapy (group 1; G 1)
while 28 pts remained as controls (group 2; G2). QOL (evaluated with the MOSHIV questionnaire), ADH (self-reported by pts), effort index to take medication (El)
and GS (both assessed with 10-point Likert scales) were evaluated at baseline
(BL) and week (wk) 12. GS referred to: general facility to take medication (GF),
number of pills (NP), size of pills (SP), number of doses (ND), timetable (TT), food
conditions (FC) and preference of new treatment (PT).
Results: In G1, 1 pt had to discontinue therapy due to NVP-related hepatotoxicity. BL values did not show significant differences between groups. At wk 12,
QOL was better in G1 (n=22) when compared with G2 (n=20) in the following
health dimensions: mental health (G1:75.5~ 11.3 vs G2: 60.7~ 14.8; p<0.001),
energy (G1:75~ 14.7 vs G2: 61.9~ 18.3; p=0.01) and general quality of life (Gl:
68.6~ 12.5 vs G2: 60.2~ 10.6; p=0.02). At wk 12, 94% of pts in G1 and 92% in
G2 reported an ADH 395% of consumption of medication prescribed (p=ns). El
was lower in G1 (G1:1.7~ 1.9 vs G2:5.2~ 2.3; p<0.001) and GS was significantly
higher in G1 in the following areas: GF (Gl: 9.07~ 1.3 vs G2:6.4~ 2.7; p=0.05),
NP (Gl: 7.4~ 2.3 vs G2: 3.7~ 2.9; p<0.001), ND (Gl: 9.6~ 1.1 vs G2: 6.7~ 3.1;
p=0.05) and PT (Gl: 9.4~ 1.08 vs G2: 6.1~ 2.8; p=0.03).
Conclusions: QD regimens seem to improve some health-related dimensions,
especially QOL, permit to maintain a good ADH and increase considerably pts'
satisfaction with their antiretroviral therapy
Presenting author: Carmina R. Fumaz, Ctra. Canyet s/n 08916 Badalona,
Spain, Tel.: [phone], Fax: [phone], E-mail: [email protected].
es
WePeB5835I A randomized, open-label comparison of the
tolerability of Videx EC capsules and Videx tablets
K. Henry', S. Green2, J. Mauney3, M. Perry3, J. Adams3, J. Enejosa".
1Hennepin County Medical Center, Hennepin County Medical Center, 4th Floor
North Block, ID Clinic 41lA, 701 Park Avenue, Minneapolis, MN 55415, United
States; 2Hampton Roads Medical Specialists, Hampton, VA, United States;
3pharmaResearch Corporation, Morrisville, NC, United States; 4Bristol-Myers
Squibb, Plainsboro, N J, United States
Background: Videx reduced mass tablets (tabs) are associated with GI symptoms (Sx) in some patients (pts). This study is being conducted to compare the
tolerability of Videx EC capsules and Videx tabs in HIV-infected adults.
Methods: In this prospective, randomized, open-label trial, eligible pts were receiving stable antiretroviral therapy (ART, > 2 weeks) that included Videx tabs
(no nelfinavir or amprenavir) and had a GSRS (Gastrointestinal Symptom Rating
Scale) score of > 2.0 (i.e., frequent or prolonged and troublesome) on at least
one of the following at screening (Wk -1): abdominal (abd) pain, nausea/vomiting,
borborygmus, abd distension, loose stools. At Wk 0, pts were randomized to either continue Videx tabs or to replace Videx tabs with Videx EC. At Wk 2, Videx
EC was dispensed to all pts. Pts underwent GI and other assessments at Wks

1,2,4, and 6. GI assessment tools included the GSRS and GI Sx questionnaires
completed by pts.
Results: Interim results are available from 76 pts randomized to receive Videx EC
(n=36) or Videx tabs (n=40) from Wks 0 to 2. Treatment groups were generally
similar at Wk 0 (overall median age = 40.5 yrs; 84% males). At Wk 2, the % of pts
with a GSRS score of > 2.0 on at least one of the five major GI Sx was significantly lower in pts receiving Videx EC versus Videx tabs (34% vs. 84%; p<0.001).

Also, the % of pts reporting assessment scores of moderate or higher for one or
more selected GI Sx (nausea, bloating, upset stomach, stomach cramps, or diarrhea) at Wk 2 was significantly lower in pts receiving Videx EC vs. Videx tabs
(22% vs. 61%; p=0.004). At Wk 6, 98% of pts preferred Videx EC.
Conclusions: Videx EC is associated with improved GI tolerability and is preferred over Videx tabs.
Presenting author: Keith Henry, Hennepin County Medical Center, 4th Floor
North Block, ID Clinic 41A, 701 Park Avenue, Minneapolis, MN 55415, United
States, Tel.: [phone], Fax: [phone], E-mail: keithH6680@aol.
com
WePeB5836 Factors associated with understanding of
antiretroviral therapy among HIV-infected patients
in Belo Horizonte, Brazil
M.G.B. Ceccato, FA. Acurcio, G.M. Rocha, P.F. Bonolo, M.D.C. Guimardes.
Federal University of Minas Gerais, Rua Desembargador Fernado Bhering, 426,
Belo Horizonte, Minas Gerais, CEP 31.260-260, Brazil
Background: Low level of understanding can contribute for poor adherence to
the antiretroviral therapy (ARVT). To assess factors associated with insuficient
understanding of information related ARVT among HIV-infected patients enrolled
in two public AIDS referral services, Belo Horizonte, Brazil.
Methods: A cross-sectional analysis, based on confidential interviews with outpatient HIV-infected individuals, after first deliverance of antiretrovirals (ARV). It
was evaluated the influence of selected variables on the understanding level of
information about ARVT. This level was classified as insufficient if there was disagreement of more than 35% between reported information by the patient and
written prescription of selected itens (e.g. ARV name, frequency, dosage). Analysis included: chi-square and Odds Ratio (OR) with 95% confidence interval (CI).
Results: Of the first 256 participants, 15.9% presented an insufficient level of
understanding regarding the prescribed ARV. Univariate analysis showed the following factors to be associated (p< 0.05) with insufficient level of understanding: education (< 8 years) (OR=2.53; C1=1.15-5.56), income (< US$ 150,00)
(OR=4.33; CI=1.27-14.75); use of alcohol (OR=2.07; CI=1.00-4.30); none healthcare providers (OR=3.95; CI=1.26-12.26); insufficiency information provided by
pharmacist (OR=2.68; CI=1.18-6.10).
Conclusions: 1. The results disclose an important proportion of patients with
misunderstanding of information regarding prescribed ARV, mainly among those
with low level of education and income. 2. It is necessary to emphasize strategies
to increase quality of recommendations provided to these patients. 3. Improve
multidisciplinary team approach in caring for HIV-patients should be considered.
Presenting author: Maria das Gragas Ceccato, Rua Desembargador Fernado Bhering, 426, Belo Horizonte, Minas Gerais, CEP 31.260-260, Brazil, Tel.:
[phone], Fax: [phone], E-mail: mgbceccato@zipmail.
com.br
WePeB5837 Quality of physician-patient adherence dialogue,
age, African American race, and mental health
independently predict self-reported antiretroviral
adherence.B. Wilson1, J. Schneider2. 1 New England Medical Center, New England
Medical Center, Box 345, 750 Washington St., Boston, MA 02111, United
States; 2University of Chicago, Chicago, II, United States
Background: It is often asserted that better physician-patient (MD-PT) relationships result in higher rates of adherence (ADH) with recommended therapies. We
examined the association between 7 different measures of MD-PT relationships
and ADH with antiretroviral therapy (ART).
Methods: We sampled experienced HIV providers in Boston (n=22) and their patients (n=552). We measured ADH using a 4-item validated scale (alpha=0.72)
that asked about trequency of changes from prescribed ART regimes. We measured quality ot MD-PT relationships using 6 published scales (general communication, HIV-specific information, participatory decision making, overall satisfaction, willingness to recommend MD, and MD trust; alpha>0.70 for all) and one
new scale, ADH dialogue (alpha=0.92). For ADH dialogue, patients rated their
MD at understanding and solving problems with ART regimens. Covariates included sociodemographic variables and health status. Separate linear regression
models were estimated for each of the 7 measures, adjusting for age, gender,
education, race, physical and mental health (all significant in bivariate tests), and
for patient clustering.
Results: Mean age was 42 years, 17% were female, 71% were white, and 66%
were gay or bisexual. In multivariable models, ADH dialogue (p=0.0005) was the
only MD-PT relationship variable significantly associated with ADH. In all 7 models worse ADH was independently associated (p<.01) with lower age, African
American race, and worse mental health.
Conclusions: A good MD-PT relationship is not necessarily produce good ad
herence. Optimizing patients' ADH probably requires detailed and specific information gathering and problem solving directed at specific dosing times and/or
specific medications. In clinical practice, identification and treatment of mental
disorders such as anxiety and depression may improve ADH. Special attention to
the ADH problems of younger and African American patients is warranted.
Presenting author: Ira B Wilson, New England Medical Center, Box 345, 750