A combination of poor adherence and a low baseline susceptibility score is highly predictive for HAART failure.
The relationship between adherence, virological response to highly active antiretroviral therapy (HAART) and the presence and development of genotypic resistance was assessed in 41 HIV-infected patients on HAART. Four adherence parameters (drug taking adherence, dosing adherence, timing adherence and drug holidays) were scored prospectively using electronic event monitoring. Genotypic resistance at baseline and after therapy failure was scored retrospectively and a genotype-based susceptibility score was calculated. Overall median adherence rates were high. All adherence parameters were better in virological responders (n=31) compared to non-responders (n=10), drug taking adherence and number of drug holidays being significantly different. Responders had a significantly higher susceptibility score. Stepwise logistic regression showed that the number of drug holidays and a low susceptibility score were highly predictive for therapy failure. Despite the presence of a limited number of baseline resistance mutations, perfectly adherent patients can control virus replication for a prolonged period.
Van Vaerenbergh
Kristien
K
Rega Institute and University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium.
De Geest
Sabina
S
Derdelinckx
Inge
I
Bobbaers
Herman
H
Carbonez
An
A
Deschamps
Ann
A
De Graeve
Veerle
V
De Saar
Veerle
V
Ceunen
Helga
H
De Smet
Koen
K
Maes
Bart
B
Peetermans
Willy
W
Schrooten
Yoeri
Y
Desmyter
Jan
J
De Clercq
Erik
E
Van Ranst
Marc
M
Van Wijngaerden
Eric
E
Vandamme
Anne-Mieke
AM
D000328:Adult; D000465:Algorithms; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D024882:Drug Resistance, Viral / Q000235:genetics; D004581:Electronics; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis; D017211:Treatment Failure; D016312:Treatment Refusal; D019562:Viral Load
D012367:RNA, Viral