Abstract
Background: Compliance plays a major role in success of antiretroviral therapy (ART) since it requires lifelong treatment and is associated with side effects. Decrease in patient compliance attenuates the clinical effectiveness, so in this regard, both patient and the health-care providers face significant challenges with respect to adherence to highly active ART (HAART). Therefore, there is a need to identify the various factors which influence the patient compliance to ensure better outcome.

Aims and Objectives: This study aims to assess the patient compliance of National AIDS Control Organization (NACO) recommended HAART regimen and to explore the impact of CD4 count with factors affecting compliance.

Materials and Methods: The prospective study conducted to assess the patient adherence to NACO recommended HAART among newly enrolled patients in ART center at KIMS Hospital and Research Centre, Bangalore, during January 2010–June 2011 (18 months) after obtaining institutional ethics committee approval. HAART consisting of two NRTIs and one NNRTI was instituted in 158 properly selected subjects. The initial therapy in most of the subjects was AZT+3TC+NVP. AZT was substituted by d4T in patients with Hb% <8G. NVP was substituted by EFV in the event of non-availability, adverse effects, or possible interactions. All the subjects received cotrimoxazole prophylaxis. Patients were monitored for 24 weeks at regular intervals. Patients were monitored for any side effects and adverse drug reactions/events during the study period. Patient compliance for adherence to therapy was assessed by pill count method.

Results: There was a good compliance with 85.26% of study subjects showed >95% compliance and only 2.07% were poorly compliant in adherence to medication. 10.12% of the subjects were lost to follow-up during ART and death occurred in 5.71% of subjects (n = 9). The good compliance was due to effective counseling and involvement of field workers for outreach follow-up.

Conclusion: The NACO-sponsored HAART regimen was found to have good compliance with greater improvement in adherence during subsequent follow-up period due to providing the backup services for effective patient counseling, outreach field visits, and transport facilities that may uplift the quality of care.

Key words: Acquired Immunodeficiency Syndrome; Human Immunodeficiency Virus; Highly Active Antiretroviral Therapy; Compliance; Adherence