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Background Patients with chronic hepatitis B (CHB) require long treatment in order to be able to achieve and maintain viral suppression. Therapy health outcomes are affected by how long and how the patients take their medications. Thus persistence should be defined and measured separately from adherence. For that reason we thought it would be interesting to analyse persistence on account of the limited number of studies that at present exist. Purpose To determine persistence among patients receiving nucleos (t)ide analogues (NUC) for CHB and to analyse the evolution of treatment persistence. Material and methods We conducted a retrospective study that included patients with CHB who initiated antiviral therapy and were attending the pharmaceutical care office between January 2002 and December 2011. Patients included in a clinical trial or who did not personally collect their medication were excluded. The variables were: age, gender, antiretroviral therapy (ART), reason for switch to another NUC and persistence. Patients were stratified according to the genetic barrier (GB) of the therapy (high GB therapies: tenofovir and entecavir and low GB therapies: lamivudina, adefovir and lamivudina plus adefovir). We used the Kaplan-Meier method to analyse non-persistence over the time of the study and to calculate the number of patients at risk of non-persistence each year. Results 102 patients were included. Most were men (72.5%). Average age was 45 ± 13 years. Lamivudine was prescribed in 32.4% of patients, entecavir in 24.5%, adefovir in 17.6%, tenofovir in 15.6% and lamivudine plus adefovir in 9.8%. The reasons for switching to another NUC were: breakthrough (72.7%), other (15.2%) and non-responder (12.1%). There was a statistically significant difference between low GB drugs (31.95; 95% CI 26.04 to 37.86) and high GB drugs (41.35; 95% CI 34.47 to 48.32 months). Log rank test: p = 0.008. Conclusion This study showed that high GB drugs had a better profile of persistence in the initial therapy of patients with CHB. The main reason for switching to another ART was breakthrough. These data will help in designing educational programmes, supporting pharmacist intervention to improve persistence to NUC for hepatitis B. References and/or Acknowledgements Cramer JA, Roy A, Burrell A, et al . Medication compliance and persistence: terminology and definitions. Value Health 2008;11:44-7 No conflict of interest.

Background Highly active antiretroviral therapy (HAART) has significantly reduced morbidity and mortality, transforming HIV into a chronic disease. The increase in life expectancy in these patients has led to a higher prevalence of comorbidities and use of concomitant medicines, which may limit adherence and therapeutic success. Purpose To determine the prevalence of other chronic diseases in HIV-infected patients and to identify predictors of non-adherence to HAART. Material and methods Single-centre retrospective study that included HIV-infected patients on HAART who attended pharmaceutical care at a pharmacy service from January to December 2013. The dependent variable was non-adherence to HAART (patients were considered non-adherent to HAART if the percentage of adherence through dispensing records was ≤90%). The independent variables were: sex, age, number of chronic diseases and concomitant medicines, and the presence of specific diseases (viral liver disease, dyslipidaemia, central nervous system disease, cardiovascular disease or hypertension). Statistical analysis: to identify independent predictors of non-adherence, we performed a multivariate logistic regression analysis. Results A total of 598 patients were analysed. 78.9% were men, mean age was 48 years (IQR: 42–52). The average number of comorbidities per patient was 1.6 ± 1.4. 31.3% of patients had viral liver disease, 17.9% dyslipidaemia, 15.6% central nervous system disease and 14.4% cardiovascular disease or hypertension. The average number of concurrent drugs per patient was 1.9 ± 2.7. 85.3% of patients were adherent to HAART. In the multivariate analysis, presence of viral liver disease was the only variable significantly associated with non-adherence to HAART (OR: 1.81); p = 0.02). The number of chronic diseases and concurrent drugs was not associated with non-adherence. Conclusion The prevalence of other chronic diseases in HIV-infected patients was high. The presence of viral liver disease was identified as a predictor of non-adherence in HIV-patients in this study. Reference Gleason LJ, et al. Polypharmacy in the HIV-infected older adult population. Clin Interv Aging 2013;8:749–63 No conflict of interest.

Background As people with HIV infections age, comorbidities and complications have increased and could affect antiretroviral therapy (ART) adherence. Purpose To determine the comorbidities of patients with HIV infection, as well as to evaluate their contribution to ART adherence. Materials and methods A twelve-month retrospective observational study (from January 2012 to December 2012) was conducted in HIV-infected patients who were being treated with ART. ART adherence was the dependent variable. We collected the following independent variables: sex, age, HCV coinfection, transmission risk, CD4 + T-cell count, HIV viral load, ART-naive, type of ART and comorbidities. We defined polypathological patients as patients with two or more chronic conditions. Adherence was determined through dispensing pharmacy records (Total number of units dispensed/Total number of units needed×100) and the simplified medicines adherence questionnaire (SMAQ). Patients who took at least 90% of their prescribed ART were classified as good adherers. We performed a univariate logistic regression to determine the relationship between the comorbidities and ART adherence. Results We included 536 patients in the study (80.2% men, mean age 47 ± 7.1 years) of whom 49.2% were HIV-HCV co-infected. Injected drug use was the main mode of HIV transmission. The median CD4 + was 574.5 cells/mm 3 (IQR: 353.8–776.3) and viral suppression ( Conclusions There is an important number of polypathological HIV-infected patients. Despite ART adherence being high, the presence of these comorbidities significantly reduces adherence. No conflict of interest.