title: A combination of poor adherence and a low baseline susceptibility score is highly predictive for HAART failure.
abstract: 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.
authors.affiliation: Rega Institute and University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Van Vaerenbergh
authors.forename: Sabina
authors.initials: S
authors.lastname: De Geest
authors.forename: Inge
authors.initials: I
authors.lastname: Derdelinckx
authors.forename: Herman
authors.initials: H
authors.lastname: Bobbaers
authors.forename: An
authors.initials: A
authors.lastname: Carbonez
authors.forename: Ann
authors.initials: A
authors.lastname: Deschamps
authors.forename: Veerle
authors.initials: V
authors.lastname: De Graeve
authors.forename: Veerle
authors.initials: V
authors.lastname: De Saar
authors.forename: Helga
authors.initials: H
authors.lastname: Ceunen
authors.forename: Koen
authors.initials: K
authors.lastname: De Smet
authors.forename: Bart
authors.initials: B
authors.lastname: Maes
authors.forename: Willy
authors.initials: W
authors.lastname: Peetermans
authors.forename: Yoeri
authors.initials: Y
authors.lastname: Schrooten
authors.forename: Jan
authors.initials: J
authors.lastname: Desmyter
authors.forename: Erik
authors.initials: E
authors.lastname: De Clercq
authors.forename: Marc
authors.initials: M
authors.lastname: Van Ranst
authors.forename: Eric
authors.initials: E
authors.lastname: Van Wijngaerden
authors.forename: Anne-Mieke
authors.initials: AM
authors.lastname: Vandamme
mesh_terms: 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
chemical_list: D012367:RNA, Viral