Unexpected CD4 decay and hidden adherence gaps

Dataset of hidden non adherent patients related to paper "Unexpected CD4 decay, hidden adherence gaps, resilience and the need for long-acting therapy in a single HIV outpatients’ cohort"
This study examines hidden non-adherence to antiretroviral therapy in a setting of persistent optimal viral suppression but concordant absolute and percent CD4 decay by >10% from the previous test. Investigated, 25% admitted very long treatment interruptions, compensated by treatment resumption before the subsequent testing. Of 668 HIV-infected subjects, 61 fulfilled the pre-specified criteria for significant CD4 decay and 15 (2.25%) admitted treatment interruptions. Eleven treatment interruptions exceeded 28 days, and none was shorter than 15 days. CD4 recovery was worse at 6 months in non-adherent subjects (-0.5 vs + 16/mmc, p<0.0001) and in non adherence vs immune decay time-related with COVID-19 (0 vs + 22/mmc, p<0.0001). Reasons for interrupting treatment were travel, psychological, poverty-related, addiction and love problems. Long-acting regimens, with stringent control of precision in timely administration, may protect PLWH from damaging their health status and possibly transmit HIV.

隐匿性不依从患者数据集，关联论文《单中心HIV门诊队列中意外的CD4细胞计数下降、隐匿性服药依从性缺口、免疫韧性与长效治疗的必要性》（"Unexpected CD4 decay, hidden adherence gaps, resilience and the need for long-acting therapy in a single HIV outpatients’ cohort"）。本研究针对持续实现最优病毒学抑制、且CD4细胞绝对计数及百分比较上次检测均下降超10%的队列，探讨患者对抗逆转录病毒疗法（antiretroviral therapy）的隐匿性不依从情况。在受访对象中，25%的患者承认存在长时间治疗中断，并在后续检测前恢复服药以弥补中断带来的影响。在668名HIV感染者中，共有61名符合预先设定的显著CD4细胞下降标准，其中15名（占比2.25%）承认存在治疗中断行为。11次治疗中断时长超过28天，无一次短于15天。不依从患者在6个月时的CD4细胞恢复情况显著更差（-0.5 vs +16/立方毫米，p<0.0001）；在合并COVID-19相关免疫下降的不依从患者亚组中，其CD4恢复情况同样不佳（0 vs +22/立方毫米，p<0.0001）。治疗中断的原因包括出行、心理问题、贫困相关因素、成瘾行为及情感婚恋问题。严格把控给药及时性与精准度的长效治疗方案，可保护人类免疫缺陷病毒感染者（People Living with HIV, PLWH）避免健康状况受损，并可能降低HIV传播风险。