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- Title
Similar Adherence Rates Favor Different Virologic Outcomes for Patients Treated with Nonnucleoside Analogues or Protease Inhibitors.
- Authors
Maggiolo, Franco; Ravasio, Laura; Ripamonti, Diego; Gregis, Giampietro; Quinzan, Giampaolo; Arici, Claudio; Airoldi, Monica; Suter, Fredy
- Abstract
therapy (HAART) completed a self-reported questionnaire derived from the Adult AIDS Clinical Trials Group Adherence Follow-up Questionnaire. Patients were followed up for the subsequent ≥6 months to document virologic failure, which was defined as 2 consecutive viral load measurements of >500 HIV RNA copies/mL. Results. Only the type of treatment and the adherence rate at baseline were significantly associated with the virologic end point. Among patients who reported an adherence rate of <75%, the rate of virologic failure was 17.4%; this rate decreased to 12.2% for patients whose adherence rate was 76%-85%, to 4.3% for patients whose adherence rate was 86%-95%, and to 2.4% for patients whose adherence rate was >95%. When analysis was adjusted according to the type of regimen received, patients who were receiving protease inhibitor (Pi)-based HAART and who had an adherence rate of up to 85% had a virologic failure rate of >20%, whereas, only for patients who were receiving nonnucleoside reverse-transcriptase inhibitor (NNRTI)-based HAART and who had an adherence rate of C75%, the virologic failure rate was >10%. For the comparison of NNRTI-treated patients and Pi-treated patients with an adherence rate of 75%-95%, the odds ratio was 0.157 (95% confidence interval, 0.029-0.852). The number of pills and daily doses received correlated with the reported adherence rate. Conclusions. Patients receiving NNRTIs report a higher rate of adherence than do patients receiving Pis. Adherence is significantly influenced by the number of pills and daily doses received. Low adherence is a major determinant of virologic failure; however, different therapies have different cutoff values for adherence that determine a significant increment of risk.
- Subjects
HIV-positive persons; NUCLEOSIDES; THERAPEUTICS; PROTEASE inhibitors; NUCLEIC acids; CLINICAL medicine
- Publication
Clinical Infectious Diseases, 2005, Vol 40, Issue 1, p158
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1086/426595