Relación entre la adherencia al tratamiento antirretroviral en pacientes VIH+ y el consumo de alcohol, asociado o no al uso de otras sustancias

Sara González-Álvarez, Agustín Madoz-Gúrpide, Carlos Parro-Torres, Daniel Hernández-Huerta, Enriqueta Ochoa Mangado

Resumen


El consumo perjudicial de alcohol es un diagnóstico de elevada prevalencia en pacientes VIH+. Distintos estudios han destacado la influencia negativa del mismo sobre la adherencia al tratamiento antirretroviral, aunque pocos de ellos valoran además el consumo de otras sustancias. En España, el consumo de alcohol se presenta frecuentemente en situación de policonsumo, fundamentalmente de cannabis y cocaína. El objetivo es comprobar cómo influye el consumo de alcohol, asociado o no al uso de otras sustancias (cocaína, heroína, metadona y/o cannabis), en la adherencia al tratamiento antirretroviral en nuestro entorno. Se ha realizado un estudio observacional tipo casos y controles sobre una muestra de 119 individuos VIH+. Conforman los casos (n=40) sujetos no adherentes al tratamiento farmacológico según reporte de Farmacia Hospitalaria, corroborado por el Simplified Medication Adherence Questionnaire (SMAQ) y la opinión del profesional de referencia. Se consideran controles (n=79) una muestra de pacientes de características similares con buena adherencia terapéutica según los mismos métodos de valoración. La recogida de datos se hizo entre mayo 2013 y septiembre 2015. El análisis estadístico se realizó mediante regresión logística binaria. Los resultados muestran que el consumo de alcohol empeora la adherencia al tratamiento antirretroviral. El uso de metadona supone un incremento estadísticamente significativo del riesgo de no adherencia. No se han encontrado diferencias significativas entre los grupos del estudio respecto a los consumos de cocaína, heroína o cannabis. Por tanto, la detección del consumo de sustancias, especialmente de alcohol, y su abordaje en pacientes VIH+ puede repercutir positivamente en el cumplimiento terapéutico, en beneficio de una mayor efectividad de la terapia antirretroviral.

Palabras clave


VIH; Terapia antirretroviral (TARGA); Adherencia terapéutica; Trastorno por uso de alcohol; Policonsumo.

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Referencias


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DOI: https://doi.org/10.20882/adicciones.916

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