Limited Patient Adherence to Highly Active Antiretroviral Therapy for HIV-1 Infection in an Observational Cohort Study

Abstract

TREATMENT OF human immunodeficiency virus type 1 (HIV-1)–infected patients with highly active antiretroviral therapy (HAART) has been shown to be effective with respect to the suppression of plasma HIV-1 RNA below detectable concentrations.^1,2 However, the effectiveness of HAART to achieve and sustain viral suppression may be hampered by insufficient patient adherence to the antiretroviral regimen.^2-6 Moreover, suboptimal adherence, allowing ongoing viral replication, facilitates the emergence of HIV-1 variants resistant to the drugs being used.^2,7 The emergence of drug resistance reduces considerably the treatment options for the individual patient, since cross-resistance exists to a large extent among antiretroviral agents within a therapeutic class.⁷ Given the potential for transmission of drug-resistant HIV-1, suboptimal adherence may have significant public health implications.^8,9