Virology Research Today is a free monthly online journal that collates and summarizes the latest research about Virology, including details on viruses, pathology, classification, definitions. | ||||||||
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HIV-infected patients receiving lopinavir/ritonavir-based antiretroviral therapy achieve high rates of virologic suppression despite adherence rates less than 95%.Shuter J, Sarlo JA, Kanmaz TJ, Rode RA, Zingman BS AIDS Center and Division of Infectious Diseases, Montefiore Medical Center, Bronx, NY 10467, USA. jshuter@montefiore.org BACKGROUND: The observation that extremely high levels of medication adherence are required to achieve complete virologic suppression is based largely on studies of treatment-experienced patients receiving HIV protease inhibitor (PI)-based therapy without ritonavir boosting. This study aims to define the level of adherence needed to achieve virologic suppression in patients receiving boosted PI-based highly active antiretroviral therapy (HAART) with lopinavir/ritonavir. METHODS: HIV-infected adults receiving a regimen containing lopinavir/ritonavir were recruited into a prospective, observational study of the relation between adherence to lopinavir/ritonavir and virologic outcomes. Adherence was measured using the Medication Event Monitoring System (MEMS; Aardex, Union City, CA). HIV-1 viral load (VL) was measured at week 24. RESULTS: The final study population contained 64 subjects. Eighty percent had AIDS, 97% received lopinavir/ritonavir before enrollment, and most had more than 7 years of HAART experience. Mean adherence overall was 73%. Eighty percent and 59% achieved a VL <400 copies/mL and a VL <75 copies/mL, respectively. Mean adherence was 75% in those achieving a VL <75 copies/mL. High rates of virologic suppression were observed in all adherence quartiles, including the lowest quartile (range of adherence: 23.5%-53.3%). CONCLUSIONS: Moderate levels of adherence can lead to virologic suppression in most patients taking lopinavir/ritonavir-based HAART. Published 26 April 2007 in J Acquir Immune Defic Syndr, 45(1): 4-8.
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