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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
HIV treatment adherence, drug resistance, virologic failure: Evolving concepts
Infectious Disorders - Drug Targets, Volume 11, No. 2, Year 2011
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Description
Poor adherence to combined antiretroviral therapy (cART) has been shown to be a major determinant of virologic failure, emergence of drug resistant virus, disease progression, hospitalizations, mortality, and health care costs. While high adherence levels can be achieved in both resource-rich and resource-limited settings following initiation of cART, long-term adherence remains a challenge regardless of available resources. Barriers to optimal adherence may originate from individual (biological, socio-cultural, behavioral), pharmacological, and societal factors. Although patients and providers should continuously strive for maximum adherence to cART, there is accumulating evidence that each class of antiretroviral therapy has specific adherence-drug resistance relationship characteristics allowing certain regimens more flexibility than others. There is not a universally accepted measure for cART adherence, since each method has distinct advantages and disadvantages including cost, complexity, accuracy, precision, intrusiveness and bias. Development of a real-time cART adherence monitoring tool will enable the development of novel, pre-emptive adherence-improving strategies. The application of these strategies may ultimately prove to be the most cost-effective method to reduce morbidity and mortality for the individual and decrease the likelihood of HIV transmission and emergence of resistance in the community. © 2011 Bentham Science Publishers Ltd.
Authors & Co-Authors
Nachega, J. B.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
United States
The Department of Medicine and Centre for Infectious Diseases
Marconi, Vincent Charles
United States, Atlanta
Emory University School of Medicine
Van Zyl, Gert Uves
United States
The Department of Medicine and Centre for Infectious Diseases
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Gardner, Edward Michael
United States, Denver
University of Colorado Denver
Preiser, Wolfgang
United States
The Department of Medicine and Centre for Infectious Diseases
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Hong, Steven Y.
United States, Boston
Tufts University School of Medicine
Mills, Edward J.
Canada, Vancouver
The University of British Columbia
Gross, Robert
United States, Philadelphia
University of Pennsylvania
Statistics
Citations: 17
Authors: 8
Affiliations: 8
Identifiers
Doi:
10.2174/187152611795589663
ISSN:
18715265
Research Areas
Infectious Diseases