Improving the Adherence to Antiretroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment-Clinical Points of View and Practical Considerations.
Improving the Adherence to Antiretroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment-Clinical Points of View and Practical Considerations.
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DOI：
10.3389/fphar.2017.00831
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发表时间：
2017
影响因子：
5.6
通讯作者：
Jugulete G
中科院分区：
文献类型：
--
作者：
Iacob SA;Iacob DG;Jugulete G
艾滋病毒感染是人类最具破坏性的流行病之一。抗逆转录病毒疗法的出现改变了这一大流行病的进程，挽救了数百万人的生命。自1996年以来，人们引入了复杂的治疗方案，这些方案有助于将艾滋病毒感染转化为可治疗的慢性疾病。新型强效抗逆转录病毒药物及其组合，包括“每日一次”治疗，简化了治疗方案，减少了副作用。然而，抗逆转录病毒治疗的依从性仍然不令人满意，在各种研究中，不同人群的依从性在27%至80%之间，而要求的水平为95%。抗逆转录病毒疗法依从性差是一个多因素的动态过程，给长期随访带来相当大的困难。目前解决这一问题的办法很复杂。这些标准应由多学科小组实施，并应考虑到与个人和社会因素以及与其所属人口（儿童、青少年、老年人、吸毒者等边缘化人口、被监禁的病人、性工作者等）有关的关键特征。重要的是，即使在已知依从的患者中，也应继续监测依从性。如果随后出现失败，团队应确定不遵守的原因并采用适当的方法。在通常的方法没有成功的机会的情况下，可以提供一套协调的服务，也称为“减少危害”，以减少传播的风险。目前的文章分析了坚持抗逆转录病毒治疗的概念，这种药物的缺点和方法，可以在实践中应用，以提高依从性。重点是分析艾滋病毒感染高危群体，这些群体目前是艾滋病毒流行病蔓延的先锋。
HIV infection is responsible for one the most devastating human pandemics. The advent of antiretroviral therapy has changed the course of the pandemic and saved millions of lives. Complex therapeutic regimens have been introduced since 1996 and have contributed to the transformation of HIV infection into a treatable chronic diseases. New types of potent antiretrovirals and their combinations, including “once daily” treatment, have simplified the regimens and diminished side effects. Nevertheless the adherence to antiretroviral therapy remains unsatisfactory and varies between 27 and 80% across different population in various studies, compared with the required level of 95%. The lack of adherence to antiretroviral therapy is a multi-factorial and dynamic process which raises considerable difficulties for long-term follow-up. Current solutions to this problem are complex. These should be applied by a multidisciplinary team and should take into account key features related to both the individual and social factors as well as to the population to whom it belongs (children, teenagers, elderly, marginalized population like drug users, incarcerated patients, sex workers, etc.). Importantly, adherence should continue to be monitored even in patients known to be compliant. In case of subsequent failure the team should identify the reasons for non-adherence and apply the appropriate methods. Where usual methods have no chance of success, a coordinated package of services also known as “harm reduction” can be offered in order to reduce the risks of transmission. The current article analyses the concept of adherence to antiretroviral therapy, the shortcomings of this medication and the methods that can be applied in practice to increase adherence. Emphasis is placed on the analysis of groups at high risk for HIV infection that currently represent the spearhead with which the HIV pandemic is spreading.
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影响因子：
4.5
作者：
Fernandes RM;Cary M;Duarte G;Jesus G;Alarcão J;Torre C;Costa S;Costa J;Carneiro AV
通讯作者：
Carneiro AV
DOI：
10.1097/00126334-200202011-00002
发表时间：
2002-02-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
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作者：
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通讯作者：
Bartlett, JA
影响因子：
5
作者：
BERKMAN, LF;SYME, SL
通讯作者：
SYME, SL
影响因子：
3.8
作者：
Chaiyachati, Krisda H.;Ogbuoji, Osondu;Baernighausen, Till
通讯作者：
Baernighausen, Till
DOI：
10.1016/s2468-2667(17)30075-0
发表时间：
2017-06
期刊：
The Lancet. Public health
影响因子：
--
作者：
Elovainio M;Hakulinen C;Pulkki-Råback L;Virtanen M;Josefsson K;Jokela M;Vahtera J;Kivimäki M
通讯作者：
Kivimäki M