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CORRESPONDENCE
Year : 2016  |  Volume : 143  |  Issue : 2  |  Page : 245

Adherence to anti-retroviral drugs


Department of Pediatrics, Safdarjung Hospital, New Delhi 110 029, India

Date of Web Publication14-Apr-2016

Correspondence Address:
Manas Pratim Roy
Department of Pediatrics, Safdarjung Hospital, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.180227

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How to cite this article:
Roy MP. Adherence to anti-retroviral drugs . Indian J Med Res 2016;143:245

How to cite this URL:
Roy MP. Adherence to anti-retroviral drugs . Indian J Med Res [serial online] 2016 [cited 2020 May 25];143:245. Available from: http://www.ijmr.org.in/text.asp?2016/143/2/245/180227

Sir,

The article on adherence of people living with HIV to anti-retroviral therapy (ART) is well-timed and deserves credit for pointing out certain delicate issues [1] . However, consideration of a few points would have strengthened the study.

It is not clear why education, gender, employment status and socio-economic status were not considered for regression. Previous studies from India have found evidences that these factors influence adherence to ART in our set up where drug is provided free of cost but attending ART centres once a month may not be possible for patients challenged with sickness and economic instability [2],[3],[4] . Authors have mentioned stock-out of ART as one of the reasons for poor adherence. From programmatic point of view, it was important to know the extent of the problem as free availability of ART is a major recognized reason for adherence [4] . In addition, it is difficult to draw any conclusion from the relationship between duration of ART and poor adherence. Those who are new to ART, adherence may be an issue due to side effects. It improves when they are getting habituated (>7 months duration), as evident from the study. However, the reason for drop in adherence once they complete one year of treatment, is not clear. It might be simply due to sub-optimal grouping of patients, based on duration of ART. A study from Bengaluru has reported that the new patients (on ART for less than 6 months) or those who are taking drugs for more than 10 years are more likely to miss medication [5] . Similarly, in the present study, regrouping of patients with a longer interval (e.g. <1 year, 1-3 years or so) would have yielded meaningful conclusion about effect of duration of ART on adherence. In brief, further analysis is warranted in patients taking ART for more than one year.

Conflicts of Interests: None.

 
   References Top

1.
Pahari S, Roy S, Mandal A, Kulia S, Panda S. Adherence to anti-retroviral therapy & factors associated with it: a community based cross-sectional study from West Bengal, India. Indian J Med Res 2015; 142 : 301-10.  Back to cited text no. 1
    
2.
Sarna A, Pujari S, Sengar AK, Garg R, Gupta I, van Dam J. Adherence to antiretroviral therapy & its determinants among HIV patients in India. Indian J Med Res 2008; 127 : 28-36.  Back to cited text no. 2
    
3.
Mhaskar R, Alandikar V, Emmanuel P, Djulbegovic B, Patel S, Patel A, et al. Adherence to antiretroviral therapy in India: a systematic review and meta-analysis. Indian J Community Med 2013; 38 : 74-82.  Back to cited text no. 3
    
4.
Sahay S, Reddy KS, Dhayarkar S. Optimizing adherence to antiretroviral therapy. Indian J Med Res 2011; 134 : 835-49.  Back to cited text no. 4
    
5.
Cauldbeck MB, O'Connor C, O'Connor MB, Saunders JA, Rao B, Mallesh VG, et al. Adherence to anti-retroviral therapy among HIV patients in Bangalore, India. AIDS Res Ther 2009; 6 : 7.  Back to cited text no. 5
    




 

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