title: Do benefits of earlier antiretroviral treatment initiation outweigh harms for individuals at risk for poor adherence?
abstract: Clinicians may defer antiretroviral treatment for patients with suboptimal adherence. We used a validated computer simulation of HIV disease progression to compare alternative treatment thresholds for patients with suboptimal adherence. Earlier treatment increased life expectancy across a wide adherence range (50%-100% of doses taken). Delaying treatment for patients with suboptimal adherence may not always be appropriate.
authors.affiliation: Department of Medicine, Section of General Internal Medicine, Yale University, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA. ronald.braithwaite@va.gov
authors.forename: R Scott
authors.initials: RS
authors.lastname: Braithwaite
authors.forename: Mark S
authors.initials: MS
authors.lastname: Roberts
authors.forename: Matthew Bidwell
authors.initials: MB
authors.lastname: Goetz
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Gibert
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.forename: Kimberly
authors.initials: K
authors.lastname: Nucifora
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003198:Computer Simulation; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008017:Life Expectancy; D055118:Medication Adherence; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents