HIV treatment adherence, drug resistance, virologic failure: Evolving concepts

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dc.contributor.authorNachega J.B.
dc.contributor.authorMarconi V.C.
dc.contributor.authorvan Zyl G.U.
dc.contributor.authorGardner E.M.
dc.contributor.authorPreiser W.
dc.contributor.authorHong S.Y.
dc.contributor.authorMills E.J.
dc.contributor.authorGross R.
dc.date.accessioned2011-05-25T08:49:48Z
dc.date.available2011-05-25T08:49:48Z
dc.date.issued2011
dc.description.abstractPoor 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. © 2011 Bentham Science Publishers Ltd.
dc.description.versionArticle
dc.identifier.citationInfectious Disorders - Drug Targets
dc.identifier.citation11
dc.identifier.citation2
dc.identifier.citation167
dc.identifier.citation174
dc.identifier.issn18715265
dc.identifier.urihttp://hdl.handle.net/10019.1/14697
dc.titleHIV treatment adherence, drug resistance, virologic failure: Evolving concepts
dc.typeArticle
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