The role of adherence to antiretroviral therapy in the management of HIV infection
The role of adherence to antiretroviral therapy in the management of HIV infection
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DOI：
10.1097/qai.0b013e3180600766
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发表时间：
2007-06-01
影响因子：
3.6
通讯作者：
Conway, Brian
中科院分区：
文献类型：
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作者：
Conway, Brian
尽管多项研究证明了高效抗逆转录病毒疗法(HAART)的成功与坚持之间的关系，但坚持不足仍然是治疗结果不佳和/或缺乏持续治疗益处的最常见原因之一。针对患者相关的社会和心理障碍以及与精神健康和药物滥用以及获得保健有关的问题的干预措施可能会改善其对坚持的负面影响。然而，影响依从性的特定药物相关因素，如药片负担、给药频率、食物要求以及急性耐受性和安全性问题，是必须考虑的进一步问题，以优化依从性。幸运的是，每日一次的联合制剂和简单的剂量要求可能有助于提高依从性，从而对一些患者来说决定HAART的成败。更好地了解依从性及其决定因素，以及如何在给定的临床环境中定义具体目标，是临床医生在实现和维持长期病毒学抑制，更重要的是长期健康方面与患者成为更有效的合作伙伴的关键。
Despite multiple studies demonstrating the relation between the success of highly active antiretroviral therapy (HAART) and adherence, inadequate adherence continues to be one of the most frequent reasons for poor treatment outcomes and/or lack of sustained treatment benefits. Interventions targeting patient-related social and psychologic barriers to adherence and issues related to mental health and substance abuse and access to health care may ameliorate their negative impact on adherence. Specific drug-related factors that influence adherence such as pill burden, dosing frequency, food requirements, and acute tolerability and safety concerns, however, are further issues that must be considered to optimize adherence. Fortunately, the availability of once-daily and coformulated agents with simple dosing requirements may help to improve adherence, and thereby make the difference between success and failure of HAART for some patients. A better understanding of adherence and its determinants and how to define specific goals in a given clinical setting are keys for clinicians to become more effective partners with patients in the achievement and maintenance of long-term virologic suppression and, more importantly, long-term health.