Abstract
Poor 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.
Keywords:HIV,antiretroviral therapy adherence,virologic failure,drug resistance,outcomes,resource-rich and resource-limited settings,flexibility,complexity,real-time cART adherence monitoring tool,morbidity and mortality,cART,protease inhibitor,test and treat,HIV prevention strategies
Infectious Disorders - Drug Targets
Title: HIV Treatment Adherence, Drug Resistance, Virologic Failure: Evolving Concepts
Volume: 11Issue: 2
Author(s):Jean B. Nachega, Vincent C. Marconi, Gert U. van Zyl, Edward M. Gardner, Wolfgang Preiser, Steven Y. Hong, Edward J. Mills and Robert Gross
Affiliation:
Keywords:HIV,antiretroviral therapy adherence,virologic failure,drug resistance,outcomes,resource-rich and resource-limited settings,flexibility,complexity,real-time cART adherence monitoring tool,morbidity and mortality,cART,protease inhibitor,test and treat,HIV prevention strategies
Abstract: Poor 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.
Export Options
About this article
Cite this article as:
B. Nachega Jean, C. Marconi Vincent, U. van Zyl Gert, M. Gardner Edward, Preiser Wolfgang, Y. Hong Steven, J. Mills Edward and Gross Robert, HIV Treatment Adherence, Drug Resistance, Virologic Failure: Evolving Concepts, Infectious Disorders - Drug Targets 2011; 11 (2) .https://dx.doi.org/10.2174/187152611795589663
| DOI https://dx.doi.org/10.2174/187152611795589663 | Print ISSN 1871-5265 |
| Publisher Name Bentham Science Publisher | Online ISSN 2212-3989 |
Call for Papers in Thematic Issues
New Frontiers in Infectious Disease Research: Small-Molecule Probes and Biomarker Identification
The biological relevance of small-molecule chemical probes targeting a disease model is crucial in the early stages of drug discovery. The integration of omics technologies such as genomics, proteomics, metabolomics, immunomic, and cellular levels has greatly enhanced the ability to identify novel biomarkers and understand the complex interactions between pathogens ...read more
Related Journals
Anti-Cancer Agents in Medicinal Chemistry
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry
Current Bioactive Compounds
Current Cancer Drug Targets
Combinatorial Chemistry & High Throughput Screening
Current Cancer Therapy Reviews
Current Diabetes Reviews
Current Drug Safety
Current Drug Targets
Current Drug Therapy
Related Books
Infections and Male Infertility: General Pathophysiology, Diagnosis, and Treatment
Advancements in Cancer Research: Exploring Diagnostics and Therapeutic Breakthroughs
Common Ear Diseases in Dogs: Diagnosis and Management
Metabolic Syndrome: A Comprehensive Update with New Insights
Vector Borne Diseases: Current Trends and Public Health Perspectives
Andrographolide and its Analogs: Botanical Sources, Phytochemistry, Pharmacology, and Biotechnology
Parasitic Diseases of Goats
Concise Handbook of Epidemiology (Second Edition)
Human Papillomavirus Vaccination and Screening in the Elimination of HPV-Associated Cancers: Evidence-Based Randomized Trials
Frontiers in Clinical Drug Research-Dementia
16
- Author Guidelines
- Bentham Author Support Services (BASS)
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
- Regulation of HIF-1α at the Transcriptional Level
Current Pharmaceutical DesignGold - Old Drug with New Potentials
Current Medicinal ChemistryMitigating Alzheimer’s Disease with Natural Polyphenols: A Review
Current Alzheimer ResearchPolypharmacology Approach Against Migraine with Aura and Brain Edema for the Development of an Efficient Inhibitor and its Analogues
Current Computer-Aided Drug Design Glycogen Synthase Kinase-3 in Neurodegeneration and Neuroprotection:Lessons from Lithium
Current Alzheimer Research Disruption of the Keap1-Containing Ubiquitination Complex as an Antioxidant Therapy
Current Topics in Medicinal Chemistry Energy Balance and Carcinogenesis: Underlying Pathways and Targets for Intervention
Current Cancer Drug TargetsEmerging Targets in Neurodegeneration: New Opportunities for Alzheimer's Disease Treatment?
Current Topics in Medicinal Chemistry Recent Advances in Antiviral Agents: Established and Innovative Therapies for Viral Hepatitis
Mini-Reviews in Medicinal Chemistry Phenotypic Screening Strategies for Neurodegenerative Diseases: A Pathway to Discover Novel Drug Candidates and Potential Disease Targets or Mechanisms
CNS & Neurological Disorders - Drug TargetsRisk Factors and Metabolism of Different Brain Regions by Positron Emission Tomography in Parkinson Disease with Disabling Dyskinesia
Current Neurovascular Research Lifestyle Factors and Endothelial Function
Current Vascular PharmacologyFibroblast Growth Factor Receptor Signaling in Cancer Biology and Treatment
Current Signal Transduction TherapyInvestigation of Anticholinesterase Activity of a Series of Salvia Extracts and the Constituents of Salvia staminea
The Natural Products Journal Green Tea Extract-Patents and Diversity of Uses
Recent Patents on Food, Nutrition & AgricultureNeuronal Nitric Oxide Synthase and Sympathetic Nerve Activity in Neurovascular and Metabolic Systems
Current Neurovascular Research Review of Rational Approaches to the Treatment of Pain Management-Role forOpioids Therapies
Current Drug TherapyPhytoestrogens in Postmenopause: The State of the Art from a Chemical, Pharmacological and Regulatory Perspective
Current Medicinal ChemistryGene Therapy in the Management of Parkinson’s Disease: Potential of GDNF as a Promising Therapeutic Strategy
Current Gene TherapyCardiac Aging and Insulin Resistance: Could Insulin/Insulin-Like Growth Factor (IGF) Signaling be used as a Therapeutic Target?
Current Pharmaceutical Design