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Titolo:
Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study
Autore:
Nieuwkerk, PT; Sprangers, MAG; Burger, DM; Hoetelmans, RMW; Hugen, PWH; Danner, SA; van der Ende, ME; Schneider, MME; Schrey, G; Meenhorst, PL; Sprenger, HG; Kauffmann, RH; Jambroes, M; Chesney, MA; de Wolf, F; Lange, JMA;
Indirizzi:
Acad Med Ctr, Dept Med Psychol J4 410, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands Dept Med Psychol, Div Infect Dis,Trop Med & AIDS, NL-1100 DE Amsterdam, Netherlands Dept Med Psychol Amsterdam Netherlands NL-1100 DE Amsterdam, Netherlands Acad Med Ctr, Dept Human Retrovirol, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands Acad Med Ctr, Natl AIDS Therapy Evaluat Ctr, NL-1100 DE Amsterdam, Netherlands Acad Med Ctr Amsterdam Netherlands NL-1100 DE DE Amsterdam, Netherlands Univ Nijmegen, St Radboud Med Ctr, Dept Clin Pharm, Nijmegen, Netherlands Univ Nijmegen Nijmegen Netherlands pt Clin Pharm, Nijmegen, Netherlands Slotervaart Hosp, Dept Pharm & Pharmacol, Amsterdam, Netherlands Slotervaart Hosp Amsterdam Netherlands harmacol, Amsterdam, Netherlands Slotervaart Hosp, Dept Internal Med, Amsterdam, Netherlands Slotervaart Hosp Amsterdam Netherlands rnal Med, Amsterdam, Netherlands Erasmus Univ, Med Ctr, Dept Internal Med, Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands Internal Med, Rotterdam, Netherlands Utrecht Med Ctr, Dept Internal Med, Utrecht, Netherlands Utrecht Med Ctr Utrecht Netherlands Internal Med, Utrecht, Netherlands Univ Hosp Maastricht, Dept Internal Med, Maastricht, Netherlands Univ HospMaastricht Maastricht Netherlands ed, Maastricht, Netherlands Univ Groningen Hosp, Dept Internal Med, NL-9713 EZ Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands NL-9713 EZ ningen, Netherlands Leyenburg Hosp, Dept Internal Med, The Hague, Netherlands Leyenburg Hosp The Hague Netherlands ternal Med, The Hague, Netherlands Univ Calif San Francisco, Ctr AIDS Prevent Studies, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 16, volume: 161, anno: 2001,
pagine: 1962 - 1968
SICI:
0003-9926(20010910)161:16<1962:LPATHA>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERFORMANCE LIQUID-CHROMATOGRAPHY; PROTEASE INHIBITOR THERAPY; HUMAN PLASMA; HIV-1-INFECTED PATIENTS; ULTRAVIOLET DETECTION; VIROLOGICAL FAILURE; REPORTED ADHERENCE; INDINAVIR; NEVIRAPINE; RESISTANCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Nieuwkerk, PT Acad Med Ctr, Dept Med Psychol J4 410, POB 22700, NL-1100 DEAmsterdam, Netherlands Acad Med Ctr POB 22700 Amsterdam Netherlands NL-1100 DE nds
Citazione:
P.T. Nieuwkerk et al., "Limited patient adherence to highly active antiretroviral therapy for HIV-1 infection in an observational cohort study", ARCH IN MED, 161(16), 2001, pp. 1962-1968

Abstract

Background: Adherence to highly active antiretroviral therapy (HAART) for human immunodeficiency syndrome type 1 (HIV-1) infection is essential to sustain viral suppression and prevent drug resistance. We investigated adherence to HAART among patients in a clinical cohort study. Methods: Patients receiving HAART had their plasma concentrations of protease inhibitors or nevirapine measured and completed a questionnaire on adherence, We determined the percentage of patients who reported taking all antiretroviral medication on time and according to dietary instructions in thepast week. Drug exposure was compared between patients reporting deviationfrom their regimen and fully adherent patients. Among patients who received HAART for at least 24 weeks, we assessed the association between adherence and virologic outcome. Results: A total of 224 of 261 eligible patients completed a questionnaire. Forty-seven percent reported taking all antiretroviral medication on timeand according to dietary instructions. Patients who reported deviation from their regimen showed lower drug exposure compared with fully adherent patients (median concentration ratio, 0.81 vs 1.07; P=.001). Among those receiving HAART for at least 24 weeks, patients reporting deviation from their regimen were less likely to have plasma HIV-1 RNA levels below 500 copies/mL(adjusted odds ratio, 4.0; 95% confidence interval, 1.4-11.6) compared with fully adherent patients. Conclusions: Only half of the patients took all antiretroviral medication in accordance with time and dietary instructions in the preceding week. Deviation from the antiretroviral regimen was associated with decreased drug exposure and a decreased likelihood of having suppressed plasma HIV-1 RNA loads. Patient adherence should remain a prime concern in the management of HIV-1 infection.

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Documento generato il 22/01/20 alle ore 06:28:51