Adherence and Drug Resistance
People infected with HIV who take antiretroviral treatments sometimes find it difficult
to adhere to their drug regimens. This can be caused by the complexity of having
to take several drugs each day or the unpleasant side effects that may result from
some medicines, such as nausea and vomiting. However, when patients fail to take
their medicines, HIV has an opportunity to create more variations of itself, including
strains that are resistant to antiretroviral drugs. Therefore, it is important for
people to continue taking their medicines as prescribed by their healthcare providers.
Paradoxes of adherence and drug resistance to HIV antiretroviral therapy.
Public health debates about providing HIV antiretroviral therapy to impoverished
populations have centred on the relationship between adherence and risk of drug
Recent data indicate that each antiretroviral therapeutic class has
a unique adherence-resistance relationship. Resistance to single protease inhibitor
therapy occurs most frequently at moderate to high levels of adherence, resistance
to non-nucleoside reverse transcriptase inhibitor therapy occurs at low to moderate
levels of adherence, and resistance to ritonavir-boosted protease inhibitor therapy
is most likely to occur at middle ranges of adherence.
These dynamic relationships
should be considered in balancing the individual and public health benefits of therapy.
Information published courtesy of NIAID
This article was last modified in: 06/18/2012