Journal Article

Similar Adherence Rates Favor Different Virologic Outcomes for Patients Treated with Nonnucleoside Analogues or Protease Inhibitors

Franco Maggiolo, Laura Ravasio, Diego Ripamonti, Giampietro Gregis, Giampaolo Quinzan, Claudio Arici, Monica Airoldi and Fredy Suter

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 1, pages 158-163
Published in print January 2005 | ISSN: 1058-4838
Published online January 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/426595
Similar Adherence Rates Favor Different Virologic Outcomes for Patients Treated with Nonnucleoside Analogues or Protease Inhibitors

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. This prospective study verified the effect of adherence on the risk of virologic failure.

Methods. At enrollment in the study, a total of 543 patients who were following a steady (duration, ⩾6 months) and effective (viral load, <50 human immunodeficiency virus [HIV] RNA copies/mL) regimen of highly active antiretroviral 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 ⩽75%, 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.

Journal Article.  3594 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.