Epidemiology and Infectious Diseases

doi: https://dx.doi.org/10.25005/2074-0581-2017-19-1-98-102

V.N. Tsoy1, E.R. Rahmanov1, Т.M. Sharipov2, К.M. Bukhoriev3

1Avicenna Tajik State Medical University, Dushanbe, Tajikistan
2City Clinical Infectious Diseases Hospital, Dushanbe, Tajikistan
3City Medical Center for AIDS Control and Prevention, Dushanbe, Tajikistan

Objective: Integrated assessment of effectiveness of the highly active antiretroviral therapy (HAART) and adherence to the therapy in HIVinfected patients with clinical stages of 3 and 4.

Methods: Forty two patients receiving HAART underwent investigation. The assessment of adherence was conducted on the base of simplified questionnaire to evaluate the precision of the followed regime of taking drugs, method and counting the consumed pills. Virological, immunological and clinical criterias were used to monitor the efficacy of the therapy.

Results: According to the survey results and counted pills, a high adherence was observed in 30 (71.4%) of patients, medium in 4 (9.5%), low in 8 (19.0%). In analyze of reasons with poor adherence to the therapy are: in first place the consumption of addictive drugs, and the second: the development of side effects from HAART, which was connected with the resumption of narcotic substance and the late onset of specific therapy of HIV infectious. The efficacy of conducted antiretroviral therapy in 32 (76.2%) HIV-infected patients was observed in immunological, virological and clinical settings. The discordance between the virological and immunological responses was observed in 5 (11.9%) of patients, where immunological efficacy was not achieved in 2 patients, and virological failure was detected in 3 patients. The therapy was not effective in 5 (11.9%) of patients from the group with low level of adherence.

Conclusions: To achieve the desirable result of HAART, it is necessary of high adherence to the therapy and eradication of the negative factors that affects to it.

Keywords: HAART, effectiveness, adherence.

Download file:

  1. 90-90-90: an ambitious treatment target to help end AIDS epidemic. Geneva: UNAIDS; 2014. 40 р
  2. Virus Immunodefitsita Cheloveka – meditsina [Human Immunodeficiency Virus – medicine]: Rukovodstvo. Pod red. NA Belyakova, AG Rakhmanovoy. 2-ye izdaniye. Saint Petersburg, RF: Baltiyskiy meditsinskiy obrazovatel'nyy tsentr; 2011. 656 p.
  3. Pokrovskiy VV. (red.) VICH-infektsiya i SPID [HIV infection and AIDS]: Rukovodstvo. 2-e izdaniye. Moscow, RF: GEOTAR-Media; 2010. 192 p.
  4. Rukovodstvo o vremeni naznacheniya antiretrovirusnoy terapii i po dokontaknoy profilaktike VICH-infektsii [Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV]: Rukovodstvo. VOZ. Yevropeyskoye regional'noye byuro; 2015. 76 p.
  5. Rafiev HK, Nurov RM, Luk'yanov NB. Rezul'taty terapii v ostroy stadii VICH-infektsii sredi zaklyuchennykh [Results of therapy patients in acute stage of HIV infection among prisoners]. Avicenna Bulletin (Vestnik Avitsenny). 2012;2:138-41.
  6. Svodnoye rukovodstvo po ispol'zovaniyu antiretrovirusnykh preparatov dlya lecheniya i profilaktiki VICH-infektsii: rekomendatsii s pozitsiy obshchestvennogo zdravookhraneniya [Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach]: Rukovodstvo. VOZ. 2-ye izdaniye; 2016. 429 p.
  7. Khoffman K, Rokshtro YuK. VICH 2014-2015 [HIV 2014-2015]. Berlin, Germany: Medizin Fokus; 2014. 924 p.
  8. Bartlett D, Gallant D, Fam P. Klinicheskiye aspekty VICH-infektsii 2009-2010 [Medical management of HIV infection 2009-2010]. Moscow, RF: R.Valent; 2010. 490 p.
  9. Rafiev HK, Nurov RM, Tursunov RA. Analiz i znachimost' laboratornykh pokazateley pri VICH-infektsii sredi spetskontingenta penitentsiarnoy sistemy Tadzhikistana [Analysis and significance of laboratory indicators in HIV infection among the prisoners of Tajikistan]. Avicenna Bulletin (Vestnik Avitsenny). 2013;2:100-5.
  10. Tursunov RA, Rafiev HK, Nurov RM, Rakhmanov ER, Sharipov TM. Opportunisticheskie infektsii u VICH-infitsirovannykh bol'nykh v Respublike Tadzhikistan [Opportunistic infections in HIV-infected patients in Tajikistan]. Avicenna Bulletin (Vestnik Avitsenny). 2012;3:123-6.
  11. Ruziev MM. Osobennosti rasprostraneniya VICh-infektsii sredi osuzhdyonnykh v mestakh lisheniya svobody Respubliki Tadzhikistan [Peculiarities of the spread of HIV infection among convicted in prisons of the Republic of Tajikistan]. Vestnik Akademii meditsinskikh nauk Tadzhikistana [Bulletin of the Academy of medical sciences of Tajikistan]. 2016;3:69-76
  12. Deeks SG, Barbour JD, Grant RM, Martin JN. Duration and predictors of CD4 T-cell gains in patients who continue combination therapy despite detectable plasma viremia. AIDS. 2002;16(2):201-7.
  13. Grabar S, Kousignian I, Sobel A. Immunologic and clinical responses to highly active antiretroviral therapy over 50 years of age. Results from the French Hospital Database on HIV. AIDS. 2004;18(14):2029-38.
  14. Gilson RJ, Man SL, Copas A. Discordant responses on starting highly active antiretroviral therapy: suboptimalCD4 increases despite early viral suppression in the UK Collaborative HIV Cohort (UK CHIC) Study. HIV Med. 2010; 11:152-60.
  15. Grabar S, Le Moing V, Goujard C. Clinical outcome of patients with HIV-1 infection according to immunologic and virologic response after 6 months of HAART. Ann Intern Med. 2000;133(6):401-10.

Authors informations:

Rahmanov Erkin Rahimovich, Doctor of Medical Sciences, Full Professor, Professor at the Department of Infectious Diseases, Avicenna Tajik State Medical University

Tsoy Victoriya Nikolaevna, candidate for a degree at the Department of Infectious Diseases, Avicenna Tajik State Medical University

Sharipov Turahon Mahmudovich, Candidate of Medical Sciences, Deputy of Head Doctor at City Clinical Infectious Diseases Hospital, Dushanbe

Bukhoriev Kobiljon Mahmudovich, Candidate of Medical Sciences, Director of City Medical Center for AIDS Control and Prevention, Dushanbe

Address for correspondence:

Rahmanov Erkin Rahimovich
Doctor of Medical Sciences, Full Professor, Professor at the Department of Infectious Diseases, Avicenna Tajik State Medical University

734025, Republic of Tajikistan, Dushanbe, Rudaki Avenue, 139

Tel.: (+992) 951 916060

E-mail: erkin_rahmonov@mail.ru

Materials on the topic: