Background: For patients on Anti-Retroviral Therapy, ART, a usual strict 12-hour dosing schedule is required. Adherence to medication must be 95% or more for viral suppression. Alterations in the dosing regimen are often made by the patients during month-long fasting, Lent for Christians and Ramadan for Muslims. Using patient viral load and CD4 counts as markers, this study aims to fill the gap in knowledge of the effect of adjusting dosing schedules during month-long fasting.
Method: 40 ARV-naive participants were recruited into two groups each, 20 observing the strict 12-hour schedules (Non-Fasting group, control) while 20 of those fasting made an adjustment to a 14-hour schedule (case). They were monitored for viral load, CD4 count and other vital signs at weeks 0, 12 and 24 during routine clinic visits.
Results: At 6 months, n=14 (70% of both non-fasting control and fasting cases) of the study participants regularly picked up their ARVs. Others were lost to follow up. At 6 months, 57% (n=8/14) of the fasting group had undetectable viral loads while the non-fasting group also had 57% (n=8/14). The number of fasting participants with improved CD4 counts beyond the minimum 200cp/ml was n=8/14 (55%) at 6 months while for the non-fasting 12-hour schedulers had improved CD4 counts (n=11/14), representing 79%. At the end of the study, there was no significant difference between the viral load and CD4 counts of fasting versus non-fasting patients (p>0.05).
Conclusion: Adjusting dosing schedules during a month's fasting has no significant negative impact on virologic and immunologic outcomes in the fasting as compared to the non-fasting patients on ART provided they are adherent to their medications.
(C) 2013 Lippincott Williams & Wilkins, Inc.