부산대학교 도서관

Background: Isoniazid preventive therapy (IPT) is efficacious in prevention of tuberculosis (TB) in Human Immunodeficiency Virus (HIV) infected persons. Yet, patients' adherence to this strategy is suboptimal, its determinants are largely unknown and data are lacking from prospective cohorts. This study aimed to identify predictors of HIV patients' adherence to IPT. Methods & Materials: This prospective cohort study was conducted in the HIV/AIDS chronic care unit of Dilla University Hospital, Ethiopia, from May 2014 to February 2015. Adherence was defined as completion of the 6-month course of treatment with 90% of pills taken (measured by diary and pill count). Data was collected on potential predictors including patients' demographic and clinical characteristics. Univariable and multivariable logistic regression models were fitted to identify independent predictors of adherence to IPT. The discriminative ability of logistic regression models was assessed by the area under the Receiver Operating Characteristic (ROC) curve and corrected for over-optimism using bootstrapping techniques. Results: 162 HIV patients were included and 104 (64.2%) were adherent to IPT. In the final multivariable model, concomitant use of antiretroviral therapy (ART) and/or prophylactic cotrimoxazole therapy was associated with adherence to IPT [OR= 2.66; 95% CI (1.15, 6.17)]. Experiencing high level of HIV stigma and episodes of opportunistic infections tended to be associated with non-adherence to IPT [OR=0.51; 95% CI (0.25, 1.04)] and [OR=0.14; 95% CI (0.02, 1.15)]. The optimism-corrected area under the ROC curve of the final model was 67% [C index = 0.67; 95% CI (0.57, 0.74)]. The calibration plot showed reasonable calibration. Conclusion: HIV patients receiving ART or cotrimoxazole therapy were more likely to adhere to IPT.Werecommend studies with larger sample size to assess the effect of other potential predictors and incidence of adverse drug reaction after IPT-ART concomitant therapies. Population level and health care provider- associated determinants of IPT uptake should be investigated. [ABSTRACT FROM AUTHOR]