Do benefits of earlier antiretroviral treatment initiation outweigh harms for individuals at risk for poor adherence?
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.
Braithwaite
R Scott
RS
Department of Medicine, Section of General Internal Medicine, Yale University, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA. ronald.braithwaite@va.gov
Roberts
Mark S
MS
Goetz
Matthew Bidwell
MB
Gibert
Cynthia L
CL
Rodriguez-Barradas
Maria C
MC
Nucifora
Kimberly
K
Justice
Amy C
AC
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
D000998:Antiviral Agents