Poorer adherence may explain why black patients are less likely to achieve or maintain undetectable viral loads using a Sustiva (efavirenz)-based treatment regimen, compared with white or Hispanic patients, according to new data published in the Journal of Acquired Immune Deficiency Syndromes.
Bruce Schackman, PhD, from the Weill Medical College of Cornell University in New York City, and his colleagues examined the medical records of patients enrolled in the AIDS Clinical Trials Group (ACTG) study A5095. Previously published analysis of this study indicated that black patients were more likely to experience virologic failure—either failing to reach an undetectable viral load or a rebound in virus—on a Sustiva-containing regimen than white or Hispanic patients. To better understand this discrepancy, Schackman’s group reviewed the records of 715 patients participating in A5095 who had completed at least one self-administered adherence evaluation. Of the 715 patients, 299 were white, 260 were black and 156 were Hispanic.
The authors found that virologic failure was strongly associated with self-reported poorer adherence in black patients, but not in white patients. Researchers also found that patients who reported a negative impact of treatment on their quality of life were more likely to have virologic failure, but this factor was not associated with race.
