title: The dynamic of adherence to highly active antiretroviral therapy: results from the French National APROCO cohort.
abstract: OBJECTIVE
  Our objective was to describe the evolution of adherence to highly active antiretroviral therapy (HAART) over a 20-month period and its relationship with virologic success.
  
  
  METHODS
  Self-reported adherence, clinical, and virologic data were collected 4 (M4), 12 (M12), and 20 (M20) months after initiation of a protease inhibitor-containing regimen in the French APROCO cohort. At each visit, patients were classified as nonadherent, moderately, or highly adherent, and HIV plasma RNA was determined.
  
  
  RESULTS
  Among the 762 patients who were regularly followed until M20, the 436 patients who answered to all questionnaires, including adherence measurement, were selected for the analysis. The proportion of highly adherent patients was 55.7%, 62.2%, and 60.3% at M4, M12, and M20, respectively. A total of 137 patients (31.4%) was "always," 225 (51.6%) "sometimes," and 74 (17.0%) "never" "highly adherent" during follow-up. After multiple adjustment for known baseline predictors, virologic success after 20 months of HAART was more likely achieved in patients who were always (odds ratio [OR] 95% confidence interval [CI], 3.02 [1.64-5.58]) or sometimes (OR [95% CI], 2.15 [1.24-3.74]) "highly adherent."
  
  
  CONCLUSIONS
  Adherence behavior is a dynamic process. Continued adherence was associated with better response to therapy and should be encouraged to reduce the risk of virologic failure.
authors.affiliation: INSERM U379, Marseille; INSERM U330, Bordeaux; Faculté X-Bichat, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Carrieri
authors.forename: V
authors.initials: V
authors.lastname: Cailleton
authors.forename: V
authors.initials: V
authors.lastname: Le Moing
authors.forename: B
authors.initials: B
authors.lastname: Spire
authors.forename: P
authors.initials: P
authors.lastname: Dellamonica
authors.forename: E
authors.initials: E
authors.lastname: Bouvet
authors.forename: F
authors.initials: F
authors.lastname: Raffi
authors.forename: V
authors.initials: V
authors.lastname: Journot
authors.forename: J P
authors.initials: JP
authors.lastname: Moatti
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D005260:Female; D005602:France; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012367:RNA, Viral / Q000097:blood
chemical_list: D012367:RNA, Viral