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Adherence, quality of life and number of daily pills in a large cross-sectional study

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Journal of the International AIDS Society201013 (Suppl 4) :P116

  • Published:


  • Generalize Linear Model
  • Dose Interval
  • Virological Response
  • Visual Scale
  • Pill Burden

Purpose of the study

To assess if with current cART regimens the number of daily pills is still a determinant of adherence and quality of life (QOL).


Cross-sectional study of patients (pts) on cART followed at our centre. An adherence and QOL questionnaire was offered between March and May 2010 to all pts at drug supply; both parameters were evaluated by visual scale. Results are described as median (IQR) or frequency (%). Linear correlation was evaluated by the Spearman correlation coefficient. Generalized linear model (GLM) was applied considering adherence or QOL as alternative outcome variables.


2114 pts [aged 46.3 (41.9-51.1) years, 448 (21.3%) females, infected since 13.7 (8.0-19.2) years, treated with antiretrovirals since 11.5 (5.4-14.1) years, 260 (12.4%) of whom with a previous diagnosis of AIDS] were included in the analysis.

At the time of survey, 1793 (87%) had <50 HIV RNA copies/mL and CD4+ were 570 (403-746)/µL. Adherence and QOL were 100 (100-100)% and 83 (61-100)%, respectively; the number of daily pills in the ongoing regimen was 3 (3-5); 914 (43.2%) pts were receiving a BID and 1200 (56.8%) a QD regimen. At univariate analysis (figure), adherence was correlated to QOL but not to the number of daily pills, whereas QOL was weakly and inversely related to the number of daily pills; both adherence and QOL were not different between pts receiving a BID or QD regimen.

At GLM, after adjustment for age, gender, HIV risk factor, current CD4+, number of pills or dosing interval, adherence was associated with current HIV RNA [adjusted mean±SE: 94.3±0.48% for pts with <50 copies/mL vs 88.6±1.10% for those with ≥50 copies/mL, p<0.0001], gender [90.4±0.94% for females vs 92.5±0.60% for males, p=0.023] and current CD4+ (β=0.003 p<0.001).

When adjusting for the same variables, QOL was higher in pts with undetectable viremia (78.7±0.7% vs 74.0±1.58%; p=0.004), in males (78.3±0.89% vs 74.5±1.39%; p=0.009), in MSMs vs heterosexuals vs others [78.5±1.37% (p<0.0001) vs 77.2±1.33% (p=0.008) vs 73.3±1.07% (reference group)], and also associated with age (β=-0.25, p<0.0001), current CD4+ (β=0.011, p<0.0001), and the number of pills (β=-0.77, p=0.019), but not with dosing interval.

Figure 1


In this highly adherent population, adherence was not associated with the number of daily pills or dosing interval. QOL was associated with the pill burden, but the pill burden explained <1% of QOL. Both adherence and QOL were strongly associated with virological response.

Authors’ Affiliations

San Raffaele Scientific Institute, Infectious Diseases, Milano, Italy