Abstract

This study evaluated medication adherence following interventions and its association with cluster of differentiation 4 (CD4) cells response among patients receiving antiretroviral therapy (ART) in Specialist Hospital Sokoto, North Western Nigeria. Longitudinal study design was used. Interventions included training of health workers on adherence counseling; pre- and post-ART adherence counseling were provided to patients. Out of 1300 patients on ART who were provided interventions, 365 patients were selected using simple random technique. The CD4-cell measurements at months 0, 6, 12, 18 and 24 were extracted from the patients’ hospital records; and announced pill counts were conducted. Chi square was used to test the association between groups of variables; and P < 0.05 indicated statistical significance. Out of 365 participants sampled, data from 297 (81.4%) participants were valid for analysis. The mean age of participants was 34.7 (95%CI, 33.6 to 35.8) years; 60.9% were females and 76.4% received Zidovudine/Lamivudine/Nevirapine (AZT/3TC/NVP) regimen. The mean percent adherence was 83.4% (95%CI, 80.8% to 86.0%). The mean CD4-cells count (cells/mm₃) at ART initiation increased from 198.9 (95%CI, 180.7 to 217.1) to 396.5 (95%CI, 368.3 to 424.7) at 6 months, 428.0 (95%CI, 400.4 to 455.6) at 12 months, 427.2 (95%CI, 405.6 to 448.8) at 18 months, and 501.4 (95%CI, 469.5 to 533.3) at 24 months. This increase was statistically significant (P< 0.05). Participants’ employment and educational status, age, sex and type of ART regimens received had no significant association with medication adherence (P > 0.05).This study reported a mean adherence level that is below the required >95% necessary to achieve the goals of ART. The increase in CD4 cells count over the observation period was statistically significant at the estimated adherence level. Better immunologic outcomes may be achieved with higher adherence level.

Key words: Medication adherence, pill counts, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), antiretroviral therapy (ART), Nigeria.