 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Adherence to Anti-HIV Therapy and the Outcome of Treatment
4 July 2000 | Volume 133 Issue 1 | Page 21
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine.
The summary below is from the full report titled "Adherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV Infection." It is in the 4 July 2000 issue of Annals of Internal Medicine (volume 133, pages 21-30). The authors are D.L. Paterson, S. Swindells, J. Mohr, M. Brester, E.N. Vergis, C. Squier, M.M. Wagener, and N. Singh.
What is the problem and what is known about it so far?
Treatments containing multiple antiviral drugs have greatly improved outcomes for HIV-infected patients. Regimens that contain powerful drugs called protease inhibitors can be particularly effective. These treatments can be difficult to follow, however, because patients need to take many pills several times a day. "Adherence " is a term that means how often the patient takes a particular treatment as prescribed. Adherence to anti-HIV treatment is important because missing doses may let the virus multiply and can lead to poor outcomes.
Why did the researchers do this particular study?
To find out more about how adherence to protease inhibitor treatment is related to laboratory test results and outcomes in persons with HIV infection.
Who was studied?
Ninety-nine HIV-infected persons who received care at a Veterans Affairs Medical Center and a university hospital. All patients were prescribed medication regimens that included a protease inhibitor.
How was the study done?
Using special computerized caps that record the date and time whenever someone opens the medication bottle, the researchers measured how often patients took the protease inhibitor as prescribed. Over a follow-up period of 3 to 15 months, the researchers also collected information on patient characteristics; the number of HIV-related infections, hospitalizations, and deaths; and CD4 counts and viral loads (laboratory tests that measure the activity of HIV infection). When anti-HIV medicines are working, they increase the CD4 count and decrease the viral load.
What did the researchers find?
Eighty-one of the 99 patients completed the study. The viral load test indicated that the medicines were not working effectively in 22% of patients who took 95% or more of the protease inhibitor doses, 61% of those who took 80% to 95% of the doses, and 80% in those who took less than 80% of the doses as prescribed. Patients who took 95% or more of the doses as prescribed had fewer days in the hospital, HIV-related infections, and deaths than did patients who took protease inhibitors less often.
What were the limitations of the study?
This study included a small number of patients, and the findings may not apply equally to all HIV-infected patients. The researchers collected information about adherence to only one type of medicine, but the patients were taking many other anti-HIV medicines as well. Although computerized bottle caps are generally a good way to measure adherence, patients can open the bottle and not actually take the pills; they can also open the bottle once and remove several doses to take later.
What are the implications of the study?
Taking 95% or more of protease inhibitor doses as prescribed appears to be related to favorable outcomes for patients with HIV infection. However, improved strategies are needed to help patients take anti-HIV medications as prescribed.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  J. D. Hartzell, I. E. Janke, and A. C. Weintrob Impact of depression on HIV outcomes in the HAART era J. Antimicrob. Chemother., August 1, 2008; 62(2): 246 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Harte, M Hamill, S G Edwards, A J Copas, J Minton, V L Jones, E Allason-Jones, I G Williams, and R F Miller Evaluation of a home-delivery service for HIV-infected patients attending an inner London HIV treatment centre Int J STD AIDS, August 1, 2008; 19(8): 533 - 535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Dickinson, M. Boffito, S. H. Khoo, M. Schutz, L. J. Aarons, A. L. Pozniak, and D. J. Back Pharmacokinetic analysis to assess forgiveness of boosted saquinavir regimens for missed or late dosing J. Antimicrob. Chemother., July 1, 2008; 62(1): 161 - 167. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Chalker, T. Andualem, O. Minzi, J. Ntaganira, A. Ojoo, P. Waako, and D. Ross-Degnan Monitoring Adherence and Defaulting for Antiretroviral Therapy in 5 East African Countries: An Urgent Need for Standards J Int Assoc Physicians AIDS Care (Chic Ill), July 1, 2008; 7(4): 193 - 199. [Abstract] [PDF]
|
|
|
|
 |
|
 D. M. Simpson, S. Brown, J. Tobias, and For the NGX-4010 C107 Study Group Controlled trial of high-concentration capsaicin patch for treatment of painful HIV neuropathy Neurology, June 10, 2008; 70(24): 2305 - 2313. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Whetten, S. Reif, R. Whetten, and L. K. Murphy-McMillan Trauma, Mental Health, Distrust, and Stigma Among HIV-Positive Persons: Implications for Effective Care Psychosom Med, June 1, 2008; 70(5): 531 - 538. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. S. Zaric, A. M. Bayoumi, M. L. Brandeau, and D. K. Owens The Cost-Effectiveness of Counseling Strategies to Improve Adherence to Highly Active Antiretroviral Therapy among Men Who Have Sex with Men Med Decis Making, June 1, 2008; 28(3): 359 - 376. [Abstract] [PDF]
|
|
|
|
|
|
K. Torpey, D. Kasonde, and F. Goma The experience of patients taking the lopinavir/ritonavir (LPV/r) tablet compared with the LPV/r soft-gel capsule in Zambia Int J STD AIDS, June 1, 2008; 19(suppl_1): 1 - 4. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Leserman Role of Depression, Stress, and Trauma in HIV Disease Progression Psychosom Med, June 1, 2008; 70(5): 539 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. K. T. Wong and J. Ussher How Do Subjectively-Constructed Meanings Ascribed to Anti-HIV Treatments Affect Treatment-Adherent Practice? Qual Health Res, April 1, 2008; 18(4): 458 - 468. [Abstract] [PDF]
|
|
|
|
|
|
J. Shuter Forgiveness of non-adherence to HIV-1 antiretroviral therapy J. Antimicrob. Chemother., April 1, 2008; 61(4): 769 - 773. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Merenstein, M. F. Schneider, C. Cox, R. Schwartz, K. Weber, E. Robison, M. Gandhi, J. Richardson, and M. W. Plankey Association Between Living With Children and Adherence to Highly Active Antiretroviral Therapy in the Women's Interagency HIV Study Pediatrics, April 1, 2008; 121(4): e787 - e793. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Garcia-Gasco, I. Maida, F. Blanco, P. Barreiro, L. Martin-Carbonero, E. Vispo, J. Gonzalez-Lahoz, and V. Soriano Episodes of low-level viral rebound in HIV-infected patients on antiretroviral therapy: frequency, predictors and outcome J. Antimicrob. Chemother., March 1, 2008; 61(3): 699 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Hodder Know Your Patient: What Conditions Affect Initial HIV Treatment Success? J Int Assoc Physicians AIDS Care (Chic Ill), March 1, 2008; 7(1_suppl): S5 - S9. [Abstract] [PDF]
|
|
|
|
 |
|
 S. Mok and Q. Minson Drug-related problems in hospitalized patients with HIV infection Am. J. Health Syst. Pharm., January 1, 2008; 65(1): 55 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Shechter, M. D. Bailey, A. J. Schaefer, and M. S. Roberts The Optimal Time to Initiate HIV Therapy Under Ordered Health States Operations Research, January 1, 2008; 56(1): 20 - 33. [Abstract] [PDF]
|
|
|
|
|
|
B. Clotet Once-daily dosing of nevirapine in HAART J. Antimicrob. Chemother., January 1, 2008; 61(1): 13 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. March, M. Mak, and S. G. Louie Effects of pharmacists' interventions on patient outcomes in an HIV primary care clinic Am. J. Health Syst. Pharm., December 15, 2007; 64(24): 2574 - 2578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Balfour, G. A. Tasca, J. Kowal, K. Corace, C. L. Cooper, J. B. Angel, G. Garber, P. A. MacPherson, and D. W. Cameron Development and Validation of the HIV Medication Readiness Scale Assessment, December 1, 2007; 14(4): 408 - 416. [Abstract] [PDF]
|
|
|
|
|
|
M. J. Cuevas Gonzalez, L. O. Valin, M. d. R. Perez-Simon, J. L. Mostaza Fernandez, M. Alcoba Leza, V. M. Sanchez, and the HAART Adherence Working Group of the Province A Prospective Study of Adherence and Virologic Failure in HIV-Infected Patients: Role of a Single Determination of Plasma Levels of Antiretroviral Medications J Int Assoc Physicians AIDS Care (Chic Ill), December 1, 2007; 6(4): 245 - 250. [Abstract] [PDF]
|
|
|
|
 |
|
 J. D. Piette Interactive Behavior Change Technology to Support Diabetes Self-Management: Where do we stand? Diabetes Care, October 1, 2007; 30(10): 2425 - 2432. [Full Text] [PDF]
|
|
|
|
|
|
B. O. Taiwo and R. Murphy Transmitted Resistance: An Overview and Its Potential Relevance to the Management of HIV-Infected Persons in Resource-Limited Settings J Int Assoc Physicians AIDS Care (Chic Ill), September 1, 2007; 6(3): 188 - 197. [Abstract] [PDF]
|
|
|
|
|
|
L. Campero, C. Herrera, T. Kendall, and M. Caballero Bridging the Gap Between Antiretroviral Access and Adherence in Mexico Qual Health Res, May 1, 2007; 17(5): 599 - 611. [Abstract] [PDF]
|
|
|
|
 |
|
 J. B. Nachega, M. Hislop, D. W. Dowdy, R. E. Chaisson, L. Regensberg, and G. Maartens Adherence to Nonnucleoside Reverse Transcriptase Inhibitor Based HIV Therapy and Virologic Outcomes Ann Intern Med, April 17, 2007; 146(8): 564 - 573. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. T. Parsons, E. Rosof, and B. Mustanski Patient-related Factors Predicting HIV Medication Adherence among Men and Women with Alcohol Problems J Health Psychol, March 1, 2007; 12(2): 357 - 370. [Abstract] [PDF]
|
|
|
|
 |
|
 R C. Rathbun, K. C Farmer, S. M Lockhart, and J. R Stephens Validity of a Stage of Change Instrument in Assessing Medication Adherence in Indigent Patients with HIV Infection Ann. Pharmacother., February 1, 2007; 41(2): 208 - 214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Braithwaite, M. S. Roberts, and A. C. Justice Incorporating Quality of Evidence into Decision Analytic Modeling Ann Intern Med, January 16, 2007; 146(2): 133 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Javanbakht, P. Prosser, T. Grimes, M. Weinstein, and C. Farthing Efficacy of an Individualized Adherence Support Program with Contingent Reinforcement Among Nonadherent HIV-Positive Patients: Results From a Randomized Trial. J Int Assoc Physicians AIDS Care (Chic Ill), December 1, 2006; 5(4): 143 - 150. [Abstract] [PDF]
|
|
|
|
|
|
P. L. Williams, D. Storm, G. Montepiedra, S. Nichols, B. Kammerer, P. A. Sirois, J. Farley, K. Malee, and for the PACTG 219C Team Predictors of Adherence to Antiretroviral Medications in Children and Adolescents With HIV Infection Pediatrics, December 1, 2006; 118(6): e1745 - e1757. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Braithwaite, S. Shechter, M. S. Roberts, A. Schaefer, D. R. Bangsberg, P. R. Harrigan, and A. C. Justice Explaining variability in the relationship between antiretroviral adherence and HIV mutation accumulation J. Antimicrob. Chemother., November 1, 2006; 58(5): 1036 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Ramer, D. Johnson, L. Chan, and M. T. Barrett The Effect of HIV/AIDS Disease Progression on Spirituality and Self-Transcendence in a Multicultural Population. J Transcult Nurs, July 1, 2006; 17(3): 280 - 289. [Abstract] [PDF]
|
|
|
|
|
|
M. Oette, A. Kroidl, K. Gobels, A. Stabbert, M. Menge, A. Sagir, D. Kuschak, T. O'Hanley, J. G. Bode, and D. Haussinger Predictors of short-term success of antiretroviral therapy in HIV infection J. Antimicrob. Chemother., July 1, 2006; 58(1): 147 - 153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E K. Hester, H. V Chandler, and K. M Sims Fosamprenavir: Drug Development for Adherence Ann. Pharmacother., July 1, 2006; 40(7): 1301 - 1310. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. C. Rudorf and S. A. Krikorian Adverse Effects Associated With Antiretroviral Therapy and Potential Management Strategies Journal of Pharmacy Practice, August 1, 2005; 18(4): 258 - 277. [Abstract] [PDF]
|
|
|
|
|
|
M. F. Parry, P. Wright, J. Stewart, G. X. McLeod, J. Tucker, and A. R. Weinberg Impact of an Adherence Program on the Health and Outlook of HIV-Infected Patients Failing Antiretroviral Therapy. J Int Assoc Physicians AIDS Care (Chic Ill), July 1, 2005; 4(3): 59 - 65. [Abstract] [PDF]
|
|
|
|
|
|
K. Shannon, T. Kerr, C. Lai, T. Ishida, E. Wood, J. S. G. Montaner, R. S. Hogg, and M. W. Tyndall Nonadherence to antiretroviral therapy among a community with endemic rates of injection drug use. J Int Assoc Physicians AIDS Care (Chic Ill), July 1, 2005; 4(3): 66 - 72. [Abstract] [PDF]
|
|
|
|
|
|
J. D. Scott Simplifying the treatment of HIV infection with ritonavir-boosted protease inhibitors in antiretroviral-experienced patients Am. J. Health Syst. Pharm., April 15, 2005; 62(8): 809 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. L Anderson Pharmacologic Perspectives for Once-Daily Antiretroviral Therapy Ann. Pharmacother., November 1, 2004; 38(11): 1924 - 1934. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ammassari, A. Antinori, M. S. Aloisi, M. P. Trotta, R. Murri, L. Bartoli, A. d. Monforte, A. W. Wu, and F. Starace Depressive Symptoms, Neurocognitive Impairment, and Adherence to Highly Active Antiretroviral Therapy Among HIV-Infected Persons Psychosomatics, October 1, 2004; 45(5): 394 - 402. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Arribas The rise and fall of triple nucleoside reverse transcriptase inhibitor (NRTI) regimens J. Antimicrob. Chemother., September 1, 2004; 54(3): 587 - 592. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Cook, D. Grey, J. Burke, M. H. Cohen, A. C. Gurtman, J. L. Richardson, T. E. Wilson, M. A. Young, and N. A. Hessol Depressive Symptoms and AIDS-Related Mortality Among a Multisite Cohort of HIV-Positive Women Am J Public Health, July 1, 2004; 94(7): 1133 - 1140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Bangsberg, A. R. Moss, and S. G. Deeks Paradoxes of adherence and drug resistance to HIV antiretroviral therapy J. Antimicrob. Chemother., May 1, 2004; 53(5): 696 - 699. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Gulick, H. J. Ribaudo, C. M. Shikuma, S. Lustgarten, K. E. Squires, W. A. Meyer III, E. P. Acosta, B. R. Schackman, C. D. Pilcher, R. L. Murphy, et al. Triple-Nucleoside Regimens versus Efavirenz-Containing Regimens for the Initial Treatment of HIV-1 Infection N. Engl. J. Med., April 29, 2004; 350(18): 1850 - 1861. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Furfine, C. T. Baker, M. R. Hale, D. J. Reynolds, J. A. Salisbury, A. D. Searle, S. D. Studenberg, D. Todd, R. D. Tung, and A. Spaltenstein Preclinical Pharmacology and Pharmacokinetics of GW433908, a Water-Soluble Prodrug of the Human Immunodeficiency Virus Protease Inhibitor Amprenavir Antimicrob. Agents Chemother., March 1, 2004; 48(3): 791 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Singla, G. E. MacKinnon III, K. J. MacKinnon, W. Younis, and B. Field Interdisciplinary Approach to Teaching Medication Adherence to Pharmacy and Osteopathic Medical Students J Am Osteopath Assoc, March 1, 2004; 104(3): 127 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Bulgheroni, P. Citterio, F. Croce, M. Lo Cicero, O. Vigano, F. Soster, T.-C. Chou, M. Galli, and S. Rusconi Analysis of protease inhibitor combinations in vitro: activity of lopinavir, amprenavir and tipranavir against HIV type 1 wild-type and drug-resistant isolates J. Antimicrob. Chemother., March 1, 2004; 53(3): 464 - 468. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Wood, K. Arasteh, H.-J. Stellbrink, E. Teofilo, F. Raffi, R. B. Pollard, J. Eron, J. Yeo, J. Millard, M. B. Wire, et al. Six-Week Randomized Controlled Trial To Compare the Tolerabilities, Pharmacokinetics, and Antiviral Activities of GW433908 and Amprenavir in Human Immunodeficiency Virus Type 1-Infected Patients Antimicrob. Agents Chemother., January 1, 2004; 48(1): 116 - 123. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. L. Preston, P. J. Piliero, J. A. Bilello, D. S. Stein, W. T. Symonds, and G. L. Drusano In Vitro-In Vivo Model for Evaluating the Antiviral Activity of Amprenavir in Combination with Ritonavir Administered at 600 and 100 Milligrams, Respectively, Every 12 Hours Antimicrob. Agents Chemother., November 1, 2003; 47(11): 3393 - 3399. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. V. Havlir, M. C. Strain, M. Clerici, C. Ignacio, D. Trabattoni, P. Ferrante, and J. K. Wong Productive Infection Maintains a Dynamic Steady State of Residual Viremia in Human Immunodeficiency Virus Type 1-Infected Persons Treated with Suppressive Antiretroviral Therapy for Five Years J. Virol., October 15, 2003; 77(20): 11212 - 11219. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Moskowitz Positive Affect Predicts Lower Risk of AIDS Mortality Psychosom Med, July 1, 2003; 65(4): 620 - 626. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Escobar, M. Campo, J. Martin, C. Fernandez-Shaw, F. Pulido, and R. Rubio Factors Affecting Patient Adherence to Highly Active Antiretroviral Therapy Ann. Pharmacother., June 1, 2003; 37(6): 775 - 781. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Frenkel, Y. Wang, G. H. Learn, J. L. McKernan, G. M. Ellis, K. M. Mohan, S. E. Holte, S. M. De Vange, D. M. Pawluk, A. J. Melvin, et al. Multiple Viral Genetic Analyses Detect Low-Level Human Immunodeficiency Virus Type 1 Replication during Effective Highly Active Antiretroviral Therapy J. Virol., May 15, 2003; 77(10): 5721 - 5730. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. K. Inouye, S. T. Bogardus Jr, C. S. Williams, L. Leo-Summers, and J. V. Agostini The Role of Adherence on the Effectiveness of Nonpharmacologic Interventions: Evidence From the Delirium Prevention Trial Arch Intern Med, April 28, 2003; 163(8): 958 - 964. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Volberding, K. R. Baker, and A. M. Levine Human Immunodeficiency Virus Hematology Hematology, January 1, 2003; 2003(1): 294 - 313. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H K Thaker and M H Snow HIV viral suppression in the era of antiretroviral therapy Postgrad. Med. J., January 1, 2003; 79(927): 36 - 42. |
Article
