Kampala — A LARGE number of Ugandan HIV/Aids patients on antiretroviral treatment have discontinued their treatment for at least one month because of the cost, side-effects or unavailability of the medicines, according to a new study by Makerere University researchers.

The study was presented at the 14th Conference on Retroviruses and Opportunistic Infections (CROI) in Los Angeles in the United States last month. The results indicate that one in seven patients receiving antiretroviral therapy (ART) at two of Uganda's largest treatment centres had discontinued treatment, and a quarter of patients reported the need to change at least one of the drugs in their regimen.

The study was done by researchers from Makerere University Medical School and the Joint Clinical Research Centre. According to Aidsmap, a UK-based online publication on HIV/Aids issues, the researchers said their findings pose a huge challenge for ART delivery in Uganda, a resource-limited country.

"There were significant proportions of discontinuation and modification of antiretroviral therapy posing a challenge to the limited treatment options in our resource-limited setting," the team, led by Dr Ronald Kiguba from Makerere University Medical School and the Joint Clinical Research Centre, said.

The study called prevalence and factors associated with discontinuation and modification of highly active antiretroviral therapy among HIV-positive people in Kampala, recommends that there is need for harmonisation of the practice and use of the traditional and complimentary medicines with ART programmes.

The researchers evaluated 686 individuals receiving ART at two treatment centres, of whom 452 were females. The study found that 62 female patients and 32 males (13.7 per cent) had discontinued treatment.

Of those who discontinued, four in 10 cited the high cost of the drugs as the reason for discontinuing. Slightly more than 20 per cent said they had discontinued to avoid side-effects. Others discontinued because they were tired, felt depressed, felt better or were away from home.

The study said recent research has stressed the need for strict adherence to antiretroviral treatment to avoid development of drug resistance and to enhance good treatment outcomes.

Discontinuation was defined as the simultaneous stopping of all ART for at least a month in patients who have been on treatment for at least two weeks. Modification was defined as the changing or switching of at least one of the drugs used as part of an initial ART regimen for patients who have been on treatment for at least two weeks.

The main reason given for therapy modification was its adverse effects, reported in 71.8 per cent of the patients who modified at least one drug in their regimen. The unmarried, those on therapy for more than three months, those who stated ART in 2004 or earlier and individuals taking more than two pills of regimen per day were more likely to have modified ART.