Case Report: Reasons for Non-Adherence to Antiretroviral Therapy (ART) in A Retroviral Disease (RVD) Patient
Abstract
Objective:To report a case of an HIV patient who was not compliant to ART medications, and explain the reasons behind that.
Case Summary: This 36years old Malay femalewith 49kgwas attended toretroviral disease (RVD) Medication Therapy Adherence Clinic(MTAC) at Hospital Sungai Buloh (HSB) to follow up and refill her antiretroviral therapy (ART) regimen on 20thAugust 2018. She has been diagnosed with RVDsince 2004, but started her highly active antiretroviral therapy (HAART) since 2008 when she visited HSB for the first time. She was given a variety combination of HAART regimens from 2008 until 2018, and developed resistance to some of them due to her poor compliance. ART medications’ side effects and number ofpills are the main reason to default the medications. Consequently, she has failed the first line regimen, and currently has not had any good treatment regimen with virological suppressions.
Discussion:Treatment adherence is generally regarded as an important factor in achieving optimal outcomes across many disease states; in the treatment of human immunodeficiency virus (HIV), poor adherence to treatment has the potential to impact outcomes on multiple levels. The causes of poor adherence to ART are extremely diverse, and include complexity of therapeutic regimens (eg, pill burden and dosing frequency), and treatment side effects. Treatment approaches, such as the use of fixed-dose combinations of ART agents to reduce dosing complexity,giving symptomatic treatments to treat the side effects,as well as educational interventions, such as medication therapy management initiatives, have been shown to improve adherence to therapy in HIV.
Conclusion:Acase of patient, whohas failed multiple HAART regimens,was presented and reasons that lead the patient to have poor compliance and developed resistance to certain ART drugs were discussed.