OBJECTIVES: To investigate the occurrence of differential adherence to components of combination antiretroviral therapy and assess its predictors and association with virological failure and antiretroviral medication resistance. DESIGN: A secondary analysis of prospective clinical trial data. METHODS: The Flexible Initial Retrovirus Suppressive Therapies study (Community Programs for Clinical Research on AIDS 058) was a randomized trial comparing non-nucleoside reverse transcriptase inhibitor (NNRTI) versus protease inhibitor (PI) versus NNRTI plus PI-based (three-class) antiretroviral therapy in treatment-naive HIV-1-infected individuals. Adherence was assessed at months 1 and 4, and then every 4 months. Differential adherence, defined as any difference in self-reported level of adherence to individual antiretroviral medications at the same timepoint, was evaluated as a binary time-updated variable in multivariate Cox regression analyses of time to initial virological failure (HIV-RNA > 1000 copies/ml) and initial virological failure with genotypic antiretroviral resistance. RESULTS:Differential adherence was reported at least once by 403 of 1379 participants (29%), over 60 months median follow-up. Differential adherence was more commonly reported by participants randomly assigned to the three-class strategy (35%) than the NNRTI (28%) or PI (25%) strategies (P = 0.005), but was not associated with demographic or baseline disease-specific factors. Of those reporting differential adherence, 146 (36%) reported it before initial virological failure. These participants had an increased risk of initial virological failure and initial virological failure with antiretroviral resistance compared with participants without differential adherence before initial virological failure. CONCLUSION:Differential adherence was commonly reported and was associated with an increased risk of initial virological failure and initial virological failure with antiretroviral resistance.
RCT Entities:
OBJECTIVES: To investigate the occurrence of differential adherence to components of combination antiretroviral therapy and assess its predictors and association with virological failure and antiretroviral medication resistance. DESIGN: A secondary analysis of prospective clinical trial data. METHODS: The Flexible Initial Retrovirus Suppressive Therapies study (Community Programs for Clinical Research on AIDS 058) was a randomized trial comparing non-nucleoside reverse transcriptase inhibitor (NNRTI) versus protease inhibitor (PI) versus NNRTI plus PI-based (three-class) antiretroviral therapy in treatment-naive HIV-1-infected individuals. Adherence was assessed at months 1 and 4, and then every 4 months. Differential adherence, defined as any difference in self-reported level of adherence to individual antiretroviral medications at the same timepoint, was evaluated as a binary time-updated variable in multivariate Cox regression analyses of time to initial virological failure (HIV-RNA > 1000 copies/ml) and initial virological failure with genotypic antiretroviral resistance. RESULTS: Differential adherence was reported at least once by 403 of 1379 participants (29%), over 60 months median follow-up. Differential adherence was more commonly reported by participants randomly assigned to the three-class strategy (35%) than the NNRTI (28%) or PI (25%) strategies (P = 0.005), but was not associated with demographic or baseline disease-specific factors. Of those reporting differential adherence, 146 (36%) reported it before initial virological failure. These participants had an increased risk of initial virological failure and initial virological failure with antiretroviral resistance compared with participants without differential adherence before initial virological failure. CONCLUSION: Differential adherence was commonly reported and was associated with an increased risk of initial virological failure and initial virological failure with antiretroviral resistance.
Authors: Viviane D Lima; Robert S Hogg; P Richard Harrigan; David Moore; Benita Yip; Evan Wood; Julio S G Montaner Journal: AIDS Date: 2007-03-30 Impact factor: 4.177
Authors: Rodger D MacArthur; Richard M Novak; Grace Peng; Li Chen; Ying Xiang; Katherine Huppler Hullsiek; Michael J Kozal; Mary van den Berg-Wolf; Christopher Henely; Barry Schmetter; Marjorie Dehlinger Journal: Lancet Date: 2006-12-16 Impact factor: 79.321
Authors: D R Bangsberg; F M Hecht; E D Charlebois; A R Zolopa; M Holodniy; L Sheiner; J D Bamberger; M A Chesney; A Moss Journal: AIDS Date: 2000-03-10 Impact factor: 4.177
Authors: Sharon B Mannheimer; Edward Morse; John P Matts; Laurie Andrews; Carroll Child; Barry Schmetter; Gerald H Friedland Journal: J Acquir Immune Defic Syndr Date: 2006-12-01 Impact factor: 3.731
Authors: S Mannheimer; L Thackeray; K Huppler Hullsiek; M Chesney; E M Gardner; A W Wu; E E Telzak; J Lawrence; J Baxter; G Friedland Journal: AIDS Care Date: 2008-02
Authors: Sanjay Pujari; Preeyaporn Srasuebkul; Somnuek Sungkanuparph; Poh Lian Lim; Nagalingeswaran Kumarasamy; John Chuah; Ritesh N Kumar; Yi-Ming A Chen; Shinichi Oka; Jun Yong Choi; Man-Po Lee; Praphan Phanuphak; Adeeba Kamarulzaman; Christopher Lee; Zhang Fujie; Rosanna Ditangco; Vonthanak Saphonn; Thira Sirisanthana; Tuti Parwati Merati; Jeff Smith; Matthew G Law Journal: J Antivir Antiretrovir Date: 2009-11-01
Authors: H Knechten; C Stephan; F A Mosthaf; H Jaeger; T Lutz; A Cargnico; A Stoehr; S Koeppe; C Mayr; K Schewe; E Wolf; E Wellmann; A Tappe Journal: Infection Date: 2010-03-29 Impact factor: 3.553
Authors: Andrew Tomita; Suvira Ramlall; Thirusha Naidu; Sbusisiwe Sandra Mthembu; Nesri Padayatchi; Jonathan K Burns Journal: J Nerv Ment Dis Date: 2019-04 Impact factor: 2.254