Guest Open Access Plus | Free Content | About | Sign in | New Users: Sign up | Mark List  

Infectious Disorders - Drug Targets (Formerly Current Drug Targets - Infectious Disorders)

Volume 11 Issue 2
ISSN: 1871-5265
eISSN: 2212-3989

 

   All Titles

  HIV Treatment Adherence, Drug Resistance, Virologic Failure: Evolving Concepts
  pp.167-174 (8) Authors: Jean B. Nachega, Vincent C. Marconi, Gert U. van Zyl, Edward M. Gardner, Wolfgang Preiser, Steven Y. Hong, Edward J. Mills, Robert Gross
 
 
      Abstract

Poor adherence to combined antiretroviral therapy (cART) has been shown to be a major determinant of virologic failure, emergence of drug resistant virus, disease progression, hospitalizations, mortality, and health care costs. While high adherence levels can be achieved in both resource-rich and resource-limited settings following initiation of cART, long-term adherence remains a challenge regardless of available resources. Barriers to optimal adherence may originate from individual (biological, socio-cultural, behavioral), pharmacological, and societal factors. Although patients and providers should continuously strive for maximum adherence to cART, there is accumulating evidence that each class of antiretroviral therapy has specific adherence-drug resistance relationship characteristics allowing certain regimens more flexibility than others. There is not a universally accepted measure for cART adherence, since each method has distinct advantages and disadvantages including cost, complexity, accuracy, precision, intrusiveness and bias. Development of a real-time cART adherence monitoring tool will enable the development of novel, pre-emptive adherence-improving strategies. The application of these strategies may ultimately prove to be the most cost-effective method to reduce morbidity and mortality for the individual and decrease the likelihood of HIV transmission and emergence of resistance in the community.

 
  Keywords: HIV, antiretroviral therapy adherence, virologic failure, drug resistance, outcomes, resource-rich and resource-limited settings, flexibility, complexity, real-time cART adherence monitoring tool, morbidity and mortality, cART, protease inhibitor, test and treat, HIV prevention strategies
  Affiliation: Johns Hopkins University, Bloomberg School of Public Health, 615 North Wolfe Street, Suite W5031, Baltimore, Maryland 21205, USA.
 
  Key: New Content Free Content Open Access Plus Subscribed Content

Bentham Science Publishers
www.benthamscience.com

 

  Copyright © 1994 - 2014   Bentham Science Publishers