Adherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV Infection

Paterson, David L.; Swindells, Susan; Mohr, Jeffrey; Brester, Michelle; Vergis, Emanuel N.; Squier, Cheryl; Wagener, Marilyn M.; Singh, Nina

doi:10.7326/0003-4819-133-1-200007040-00004

Cited by 2,875 publications

(2,402 citation statements)

References 22 publications

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“…Previous research suggests that adherence rates of less than 90% lead to increased viral replication and development of drug-resistant HIV strains. 39,40 …”

Section: Methodsmentioning

confidence: 99%

Antiretroviral Adherence and the Nature of HIV-Associated Verbal Memory Impairment

Wright¹,

Woo²,

Foley³

et al. 2011

Journal of Neuropsychiatry

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The authors investigated the relationship between antiretroviral adherence and HIV-associated verbal memory impairment. HIV-positive participants demonstrated poorer verbal memory than HIV-negative participants. Both good (≥90%) and poor (<90%) adherers displayed encoding deficits as compared with controls, but only poor adherers exhibited retrieval deficits. Encoding deficits primarily accounted for reduced delayed recall in good adherers, but both encoding and retrieval deficits accounted for reduced delayed recall in poor adherers. The retrieval difference between the adherence groups might be explained by a neuroprotective effect of good antiretroviral adherence or preexisting HIV-related retrieval deficits that result in poorer adherence.

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“…Previous research suggests that adherence rates of less than 90% lead to increased viral replication and development of drug-resistant HIV strains. 39,40 …”

Section: Methodsmentioning

confidence: 99%

Antiretroviral Adherence and the Nature of HIV-Associated Verbal Memory Impairment

Wright¹,

Woo²,

Foley³

et al. 2011

Journal of Neuropsychiatry

View full text Add to dashboard Cite

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“…Adherence to HAART has been associated with relative improvements in immunologic and virologic markers (Low-Beer et al, 2000;Paterson et al, 2001), increased body weight (Shikuma et al, 2004), and less rapid progression to Acquired Immunodeficiency Syndrome (AIDS; Bangsberg et al, 2001). Despite the seriousness of problems related to nonadherence, empirical studies on HAART adherence interventions for HIV-positive substance users are lacking (Simoni et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Voucher reinforcement improves medication adherence in HIV-positive methadone patients: A randomized trial

Sorensen

Haug

Delucchi

et al. 2007

Drug and Alcohol Dependence

143

136

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This clinical trial evaluated a contingency management intervention designed to improve medication adherence among HIV-positive methadone maintenance patients. After a 4-week baseline observation phase, eligible participants (N = 66) were randomly assigned to: (a) medication coaching sessions every other week to assist with adherence strategies (comparison group) or (b) medication coaching plus voucher reinforcement for opening electronic medication caps on time (voucher group). Baseline adherence (percent doses taken/percent total possible doses) was 51% using electronic measurement, 75% using self-report and 75% using pill count. The intervention was provided for 12 weeks, with a 4-week follow-up. The primary outcome results of the clinical trial indicated effectiveness during the intervention, with significant mean adherence differences between voucher and comparison groups using electronic measurement (78% vs. 56%), pill count (86% vs. 75%), and self-report (87% vs. 69%). Differences between groups faded after vouchers were discontinued. Contingency management shows promise as a strategy to promote antiretroviral medication adherence in this population.

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“…However, even though an exhaustive IAS mutation list is accessible to clinicians and many free-of-charge websites [Beerenwinkel et al, 2003;Kuiken et al, 2003;Rhee et al, 2003] furnish a computer-assisted interpretation of mutational profiles, some discrepancies continue to exist between these resistance profiles and response to therapy [Kijak et al, 2003;Ravela et al, 2003;Sturmer et al, 2003;Torti et al, 2003;De Luca et al, 2004]. Although good compliance with treatment regimens [Paterson et al, 2000;Cingolani et al, 2002], optimal antiviral potency [Daar, 2003;Gathe, 2003], and adequate drug concentrations [Yasuda et al, 2004] are major concerns for obtaining a sustained control of viral replication, the major obstacle to realizing a successful regimen capable of providing a sustained control of viral replication regards some unresolved questions related to HIV-1 resistance. In particular, the relative contribution of each single mutation to antiretroviral resistance might differ [Monno et al, 2003], and has to be quantified.…”

Section: Introductionmentioning

confidence: 99%

Impact of unreported HIV‐1 reverse transcriptase mutations on phenotypic resistance to nucleoside and non‐nucleoside inhibitors

Saracino

Monno

Scudeller

et al. 2005

Journal of Medical Virology

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An extended spectrum of HIV-1 reverse-transcriptase (RT) mutations in HAART-treated patients has been recently described. To verify the possible association of previously unreported RT mutations with a decrease of phenotypic susceptibility to nucleoside (NRTIs) and non-nucleoside (NNRTIs) RT inhibitors, the RT sequence of 328 HIV-1-positive patients (102 naïve and 226 treated with HAART participating in either the PhenGen or Genpherex study) was analyzed. All treated patients were tested at the time of therapeutic failure with both phenotypic (Antivirogram 1 , Virco) and genotypic analyses (VircoGen TM ); the frequency of RT substitutions (positions 1-240) with respect to consensus B was compared to that of naïve patients using a Chi-square test. Amino acid changes at 13 positions not included in the IAS list of resistance-associated mutations were detected more frequently in treated than in naïve subjects. The mutations involving 10 of these positions were associated with a reduced susceptibility to antiretroviral drugs; K20R, T39A, K43EQN, E203KD, H208Y, and D218E were correlated with NRTI resistance while mutations K101EQP, H221Y, K223EQ, L228HR were associated to NNRTI resistance. A correlation was found between K20R and lamivudine resistance (P ¼ 0.006) while T39A (P ¼ 0.005), K43EQN (<0.001), E203KD (P ¼ 0.010), and H208Y (P ¼ < 0.001) seemed to be associated with a previous use of zidovudine and stavudine and with the development of thymidine analog resistance. For H208Y, an association with use/resistance to abacavir (P ¼ 0.004) was also noted. D218E showed a weak association to didanosine resistance (P ¼ 0.013). The data confirm that previously unreported mutations are associated with antiretroviral drug experience and, more importantly, with a reduced susceptibility to NRTIs and NNRTIs.

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Adherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV Infection

Abstract: Adherence to protease inhibitor therapy of 95% or greater optimized virologic outcome for patients with HIV infection. Diagnosis and treatment of psychiatric illness should be further investigated as a means to improve adherence to therapy.

Cited by 2,875 publications

References 22 publications

Antiretroviral Adherence and the Nature of HIV-Associated Verbal Memory Impairment

Antiretroviral Adherence and the Nature of HIV-Associated Verbal Memory Impairment

Voucher reinforcement improves medication adherence in HIV-positive methadone patients: A randomized trial

Impact of unreported HIV‐1 reverse transcriptase mutations on phenotypic resistance to nucleoside and non‐nucleoside inhibitors

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