Comparison of six methods to estimate adherence in an ART-naïve cohort in a resource-poor setting: which best predicts virological and resistance outcomes?

Orrell, Catherine; Cohen, Karen; Leisegang, Rory; Bangsberg, David R.; Wood, Robin; Maartens, Gary

doi:10.1186/s12981-017-0138-y

Table 3 The table below presents odds ratios (OR) or adjusted odds ratios (aOR) with 95% confidence intervals (CI) for failure or resistance given a 10% increase in the adherence variable (or a 1 log increase in EFV concentration) in each logistic regression model

From: Comparison of six methods to estimate adherence in an ART-naïve cohort in a resource-poor setting: which best predicts virological and resistance outcomes?

Adherence measure	Univariate model		Multivariable model
Adherence measure	OR (95% CI)	p value	aOR (95% CI)	p value
Virological failure (>40 copies/ml) at week 48
EAMD^a	0.87 (0.82–0.94)	<0.001	0.89 (0.82–0.95)	0.001
PR-average	0.78 (0.70–0.88)	<0.001	0.78 (0.69–0.87)	<0.001
PR-gaps	0.69 (0.56–0.82)	<0.001	0.68 (0.56–0.82)	<0.001
CPC	0.89 (0.82–0.96)	0.004	0.88 (0.80–0.96)	0.004
Log₁₀EFV	0.40 (0.16–1.03)	0.059	0.52 (0.19–1.37)	0.184
SR	0.98 (0.89–1.08)	0.698	0.98 (0.88–1.09)	0.720
Resistance (presence of ≥1 major mutation) at week 48
EAMD	0.74 (0.64–0.87)	<0.001	0.68 (0.53–0.88)	0.003
PR-average	0.77 (0.69–0.87)	<0.001	0.77 (0.66–0.89)	<0.001
PR-gaps	0.74 (0.65–0.85)	<0.001	0.77 (0.66–0.89)	0.001
CPC	0.85 (0.77–0.94)	0.002	0.82 (0.69–0.98)	0.031
Log₁₀EFV	0.14 (0.04–0.45)	0.001	0.14 (0.02–0.78)	0.025
SR	0.92 (0.83–1.02)	0.102	0.92 (0.78–1.08)	0.316
Virological failure (>400 copies/ml) at week 16
EAMD	0.93 (0.86–1.01)	0.085	0.96 (0.87–1.06)	0.459
PR-average	0.68 (0.55–0.83)	<0.001	0.66 (0.50–0.73)	0.004
PR-gaps	0.64 (0.51–0.82)	<0.001	0.64 (0.47–0.88)	0.006
CPC	0.89 (0.78–1.03)	0.133	0.94 (0.78–1.13)	0.491
Log₁₀EFV	0.17 (0.04–0.75)	0.020	0.20 (0.03–1.47)	0.115
SR	0.92 (0.83–1.03)	0.163	0.98 (0.83–1.01)	0.765
Resistance (presence of ≥1 major mutation) at week 16
EAMD	0.93 (0.85–1.01)	0.085	0.96 (0.86–1.07)	0.435
PR-average	0.85 (0.72–0.99)	0.036	0.87 (0.72–1.06)	0.171
PR-gaps	0.85 (0.71–1.01)	0.066	0.88 (0.69–1.11)	0.287
CPC	0.90 (0.80–1.01)	0.069	0.93 (0.82–1.06)	0.316
Log₁₀EFV	0.34 (0.08–1.81)	0.228	0.43 (0.07–2.66)	0.362
SR	0.93 (0.83–1.03)	0.147	0.97 (0.85–1.11)	0.647

Univariate models use only the adherence variable in the model with the outcome variable, multivariable models include the adherence variable and three baseline variables (CD4 cell count, log HIV-RNA and age) with the outcome variable. There are four outcome variables: the risk of virological failure to >40 copies/ml at week 48, the risk of virological failure to >400 copies/ml at week 16, the risk of resistance (presence of ≥1 IAS major mutation at genotyping) at weeks 16 and 48
^aEAMD = electronic adherence monitoring device data; PR-average = average pharmacy refill data; PR-gaps = pharmacy refill gaps data; CPC = clinic-based pill count data; EFV = efavirenz mid-dosing interval data; SR = 3-day self-recall data
Those results that are significant (p < 0.05) are in italics

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