Relationships Among Neurocognitive Status, Medication Adherence Measured by Pharmacy Refill Records, and Virologic Suppression in HIV-Infected Persons

• DOI: 10.1097/qai.0b013e31827ed678
• Publication Date: 2012-12-01T06:20:56Z
• Authors: Adriana S.A. Andrade; Reena Deutsch; Shivaun A. Celano; Nichole A. Duarte; Thomas D. Marcotte; Anya Umlauf; J. Hampton Atkinson; J. Allen McCutchan; Donald Franklin; Terry J. Alexander; Justin C. McArthur; Christina Marra; Igor Grant; Ann C. Collier
• Keywords: Neurocognitive

Optimal antiretroviral therapy (ART) effectiveness depends on medication adherence, which is a complex behavior with many contributing factors, including neurocognitive function. Pharmacy refill records offer promising and practical tool to assess adherence.A substudy of the CHARTER (CNS HIV Anti-Retroviral Therapy Effects Research) study was conducted at Johns Hopkins University (JHU) Washington. were primary method measure ART indexed "sentinel" drug highest central nervous system penetration-effectiveness score. Standardized neuromedical, neuropsychological, psychiatric, substance use assessments performed enrollment 6 months. Regression models used determine factors associated adherence relationships between changes in plasma cerebrospinal fluid RNA concentrations visits.Among 80 (33 JHU 47 Washington) participants, mean score 86.4%, no difference sites. In final multivariable model, better function especially among participants who JHU, male, infected for longer period time. Worse performance working memory tests worse adherence. Better predicted greater decreases visits.Poorer global functioning deficits lower defined by pharmacy record measure, suggesting that cognitive function, particular, may identify patients risk poor would benefit from support.