— Early sign of Alzheimer's reversed in lab — One of the earliest known impairments caused by Alzheimer's disease - loss of sense of smell - can be restored by removing a plaque-forming protein in a mouse model of the disease,…
— Parental controls on embryonic development? — When a sperm fertilises an egg, each contributes a set of chromosomes to the resulting embryo, which at these very early stages is called a zygote. Early on, zygotic genes are inert,…
— Newly discovered heart stem cells make muscle and bone — Researchers have identified a new and relatively abundant pool of stem cells in the heart. The findings in the December issue of Cell Stem Cell, a Cell Press publication, show that…
— BUSM researchers develop blood test to detect membranous nephropathy — Research conducted by a pair of physicians at Boston University School of Medicine (BUSM) and Boston Medical Centre (BMC) has led to the development of a test that can help diagnose…
— New hip implants no better than traditional implants — New hip implants appear to have no advantage over traditional implants, suggests a review of the evidence published on bmj.com today…
— Action needed to improve men's health in Europe — Policies aimed specifically at men are urgently needed to improve the health of Europe's men, say experts on bmj.com today…
— Probiotics reduce infections for patients in intensive care — Traumatic brain injury is associated with a profound suppression of the patient's ability to fight infection. At the same time the patient also often suffers hyper-inflammation, due…
— High blood sugar levels in older women linked to colorectal cancer — Elevated blood sugar levels are associated with an increased risk of colorectal cancer, according to a study led by researchers at Albert Einstein College of Medicine of Yeshiva University.…
— Engineered botulism toxins could have broader role in medicine — The most poisonous substance on Earth - already used medically in small doses to treat certain nerve disorders and facial wrinkles - could be re-engineered for an expanded role in helping…
Intensive adherence counselling with HIV treatment improves patient outcomes
Intensive adherence counselling around the time of HIV treatment initiation significantly reduces poor adherence and virologic treatment failure in sub-Saharan Africa whereas using an alarm device has no effect, according to a study in this week's PLoS Medicine by Michael Chung from the University of Washington, Seattle, USA, and colleagues.
The findings of this study define an adherence counselling protocol that is effective; these findings are relevant to other HIV clinics caring for large numbers of patients in sub-Saharan Africa.
As poor adherence to HIV treatment can lead to drug resistance and inadequate treatment, it is necessary to identify interventions to improve adherence that are inexpensive and proven to be effective in resource-limited settings. The authors randomised 400 patients who were newly diagnosed with HIV and had never before taken antiretroviral therapy to receive adherence counselling alone; alarm device alone; both adherence counselling and alarm device together; and a control group that received neither adherence counselling nor alarm device.
Patients had baseline blood taken to test for HIV-1 RNA and CD4 count and blood was then taken every 6 months for the duration of the study (18 months). After starting HIV treatment, patients returned to the study clinic every month with their pill bottles for the study pharmacist to count and record the number of pills remaining in the bottle.
Patients receiving adherence counselling were 29% less likely to experience poor adherence compared with those who received no counselling. Furthermore, those receiving intensive early adherence counselling were 59% less likely to experience virologic treatment failure. However, there was no significant difference in mortality or significant differences in CD4 counts at 18 months follow-up between those who received counselling and those who did not. There were also no significant differences in adherence, time to virologic treatment failure, mortality, or CD4 counts in patients who received alarm devices compared with those who did not.
The authors conclude: 'As antiretroviral treatment clinics expand to meet an increasing demand for HIV care in sub-Saharan Africa, adherence counselling should be implemented to decrease the development of treatment failure and spread of resistant HIV.'
Or subscribe for our Newsletter, a free e-mail publication. It is published practically every day.
Scientists create energy-burning brown fat in mice
Genome of parasitic flatworm that causes schistosomiasis decoded
MTV survey cranks up the volume on loud music's impact on hearing
New method may accelerate drug discovery for difficult diseases like Parkinson's