# Non-compliance to antiretroviral therapy readjustments following complications in HIV-positive patients in South Africa

## TL;DR

This study examines how often HIV patients in South Africa follow treatment guidelines after complications from antiretroviral therapy.

## Contribution

The study provides insights into non-compliance with ART guidelines in managing HIV-related complications in South Africa.

## Key findings

- Only 25% of hepatic failure patients and 41.3% of renal impairment patients received guideline-compliant treatment.
- 40% of patients with virological failure were re-initiated on ART according to guidelines.
- Non-compliance with ART guidelines was observed in over 40% of cases.

## Abstract

South Africa accounts for 19% of the global population living with human immunodeficiency virus (HIV), limited knowledge exists on adherence to guidelines when managing complications.

This study assesses regimen adjustment for HIV-positive patients with renal and hepatic dysfunction resulting from antiretroviral therapy (ART) according to the South African Treatment Guidelines and examines the re-initiation of ART in patients who have defaulted.

The study was conducted at Tshepang HIV Clinic, Ga-Rankuwa, Pretoria, South Africa.

A retrospective review was conducted between November 2020 and December 2020. Patients who had been on ART for over 18 months and presented with hepatic, renal and/or virological failure were included in the study. The data collection tool included demographics and medical records. Statistical Package for Social Sciences version 25 for Windows was used for data analysis.

A total of 181 files were reviewed, and only 37 were eligible for participation. The study found that treatment received by 25% of hepatic failure patients and 41.3% of renal impairment patients complied with South African ART guidelines. Furthermore, 40% of patients with virological failure were re-initiated according to guidelines.

This study found practices that were contrary to the prescribed guidelines with non-compliance accounting for more than 40%.

This study demonstrates a high incidence of adherence failure to South African ART guidelines. Defaulted patients are placed risk of antiretroviral resistance. Adherence to guidelines is important to prevent complications resulting from ART.