Non-adherence to highly active antiretroviral therapy predicts progression to AIDS
Non-adherence to highly active antiretroviral therapy predicts progression to AIDS
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DOI：
10.1097/00002030-200106150-00015
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发表时间：
2001-06-15
期刊：
影响因子：
3.8
通讯作者：
Moss, A
中科院分区：
文献类型：
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作者：
Bangsberg, DR;Perry, S;Moss, A
高效抗逆转录病毒疗法（HAART）的引入大大降低了艾滋病毒感染者的死亡率[1-4]。尽管HAART治疗的坚持程度与血浆中HIV病毒载量的抑制密切相关[5-14]，但坚持治疗与疾病进展之间的关系尚未确定。在这里，我们研究了药丸计数依从性[10]与艾滋病进展之间的关系，在无家可归者和边缘住房个体的代表性队列中。在1996年7月至2000年4月期间，330名艾滋病毒阳性个体被招募到无家可归者获得护理研究（REACH）队列中。我们对在1998年1月或之后接受HAART治疗的81名非艾滋病患者中的76名（94%）进行了依从性评估。药丸计数每3-6周在受试者通常居住的地方（单人房酒店，庇护所或其他）进行，如前所述，在未通知的日子进行。每月检测HIV-1病毒载量，每季度检测CD4细胞计数。通过旧金山公共卫生部艾滋病监测登记处进行记录匹配，用于识别研究方案中未检测到的机会性感染。在研究期间，没有患者失去随访。
The introduction of highly active antiretroviral therapy (HAART) has produced a dramatic reduction in mortality among HIV-infected individuals [1–4]. Whereas the level of adherence to HAART is closely associated with suppression of the HIV viral load in plasma [5–14], a relationship between adherence and disease progression has not been established. Here we examine the relationship between pill-count adherence [10] and progression to AIDS, in a representative cohort of homeless and marginally housed individuals.Three hundred and thirty HIV-positive individuals were recruited into the Research in Access to Care in the Homeless (REACH) cohort between July 1996 and April 2000. We performed adherence assessments in 76 of the 81 (94%) individuals without AIDS who were taking HAART on or after January 1998. Pill counts are conducted every 3–6 weeks at the subject's usual place of residence (single room occupancy hotel, shelter, or other) on an unannounced day as previously described [10]. The HIV-1 viral load was determined monthly and the CD4 cell count was determined quarterly. Record match, through the San Francisco Department of Public Health AIDS Surveillance Registry, was used to identify opportunistic infections not otherwise detected by study protocol. No patients were lost to follow-up during the study.