The Era of Adherence to HIV Therapy
Authors: Frederick L. Altice
Journal: Annals of Internal Medicine (1998)

Editorials15 September 1998The Era of Adherence to HIV TherapyFrederick L. Altice, MD and Gerald H. Friedland, MDFrederick L. Altice, MDYale University School of Medicine; New Haven, CT 06510 and Gerald H. Friedland, MDYale University School of Medicine; New Haven, CT 06510Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-6-199809150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The past 2 years have witnessed stunning benefits of antiretroviral therapy. Dramatic delays in HIV progression, improved survival, and decreased hospitalization for HIV-infected patients have created a renewed sense of optimism [1, 2]. For many, HIV disease has been transformed into a manageable chronic disease. However, complete enthusiasm for these recent successes has been dampened by biological, clinical, social, and economic realities that limit both access to and success of antiretroviral therapies. High HIV replication and mutation rates, varying potency of regimens, stage of HIV disease, and previous antiretroviral therapy all influence therapeutic success and failure. In addition, it has ...References1. Update: trends in AIDS incidence-United States, 1996. MMWR Morb Mortal Wkly Rep. 1997; 46:861-7. Google Scholar2. Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998; 338:853-60. Google Scholar3. Gulick RM, Mellors JW, Havlir D, Eron JJ, Gonzalez C, McMahon D, et al. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. N Engl J Med. 1997; 337:734-9. Google Scholar4. Deeks S, Beatty G, Cohen PT, Grant R, Volberding P. Viral load and CD4+ T cell changes in patients failing potent protease inhibitor therapy [Abstract]. Fifth Conference on Retroviruses and Opportunistic Infections, Chicago, Illinois, 1-5 February 1998. Google Scholar5. Montaner JS, Reiss P, Cooper D, Vella S, Harris M, Conway B, et al. A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS Trial. Italy, The Netherlands, Canada and Australia Study. JAMA. 1998; 279:930-7. Google Scholar6. Mellors J. Combination protease inhibitor therapy. Session 84: Update on Antiretroviral Therapy, Fourth Conference on Retroviruses and Opportunistic Infections, Washington, D.C., 22-26 January 1997. Google Scholar7. Webster's New Collegiate Dictionary. Springfield, MA: Merriam; 1977. Google Scholar8. Sackett DL, Snow JC. The magnitude of compliance and noncompliance. In: Sackett DL, Haynes RB, eds. Compliance with Therapeutic Regimens. Baltimore: Johns Hopkins Univ Pr; 1976:11-27. Google Scholar9. Mostashari FM, Riley E, Selwyn PA, Altice FL. Acceptance and adherence with antiretroviral therapy among HIV-infected women in a correctional facility. J Aquir Immune Defic Syndr Hum Retrovirol. 1998; 18:341-8. Google Scholar10. Altice FL, Mostashari F, Thompson AS, Friedland GH. Perceptions, acceptance and adherence to antiretrovirals among prisoners. Fourth Conference on Retroviruses and Opportunistic Infections, Washington, DC, 22-26 January 1997. Google Scholar11. Samet JH, Libman H, Steger KA, Dhawan RK, Chen J, Shevitz AH, et al. Compliance with zidovudine therapy in patients infected with human immunodeficiency virus, type 1: a cross-sectional study in a municipal hospital clinic. Am J Med 1992; 92:495-502. Google Scholar12. Singh N, Squier C, Sivek C, Wagener M, Nguyen MH, Yu VL. Determinants of compliance with antiretroviral therapy in patients with human immunodeficiency virus: prospective assessment with implications for enhancing compliance. AIDS Care. 1996; 8:261-9. Google Scholar13. Ickovics JR, Meisler AW. Adherence in AIDS clinical trials: a framework for clinical research and clinical care. J Clin Epidemiol. 1997; 50:385-91. Google Scholar14. Sackett DL, Haynes RB, eds. Compliance with Therapeutic Regimens. Baltimore: Johns Hopkins Univ Pr; 1976. Google Scholar15. Morse EV, Simon PM, Coburn M, Hyslop N, Greenspan D, Balson PM. Determinants of subject compliance within an experimental anti-HIV drug protocol. Soc Sci Med. 1991; 32:1161-7. Google Scholar16. Wainberg MA, Friedland GH. Public health implications of antiretroviral therapy and HIV drug resistance. JAMA. 1998; 279:1977-83. Google Scholar17. Haynes RB, McKibbon KA, Kanani R. Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications. Lancet. 1996; 348:383-6. Google Scholar18. Altice FL, Khoshnood K, Eicher A, Pinell V. Transitional case management for HIV+ prisoners in Connecticut [Abstract]. 124th Annual Meeting of the American Public Health Association, New York, NY, 1996. Google Scholar19. Bangsberg D, Tulsky JP, Hecht FM, Moss AR. Protease inhibitors in the homeless. JAMA. 1997; 278:63-5. Google Scholar20. Uchtenhagen A. Summary of the synthesis report. In: Uchtenhagen A, Gutzwiller F, Dobler-Mikola A, eds. Programme for a Medical Prescription of Narcotics: Final Report of the Research Representatives. Zurich: Institute for Social and Preventive Medicine at the University of Zurich; 1997. Google Scholar Author, Article, and Disclosure InformationAuthors: Frederick L. Altice, MD; Gerald H. Friedland, MDAffiliations: Yale University School of Medicine; New Haven, CT 06510Corresponding Author: Gerald H. Friedland, MD, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT 06510-2283.Current Author Addresses: Drs. Altice and Friedland: Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT 06510-2283. 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