Sixth International Congress Drug Therapy in HIV Infection 17-21 November, 2002 Glasgow, UK

One of the most important clinical developments in the treatment of HIV infected patients in recent years is our understanding of the truly crucial significance adherence plays in the success of HAART. Although our initial efforts in implicating combination antiretroviral therapy focused almost entirely on the pharmacological and virological aspects of the compounds – we have now learned that drug taking behavior is perhaps the single most important element in the successful management of HIV infection. The great challenge required of the patient to take drugs each and every day, always on time and often despite adverse events has become clear to the medical providers. Multiple studies have clearly shown the intimate relationship between adherence and virological success as well as the development of drug resistance. A large variety of tools have been developed and assessed in their ability to enhance drug-taking behavior in the many complex clinical settings of HIV infected individuals worldwide. Fortunately, improvements in adherence have been shown to directly augment virological response to therapy in a large variety of clinical settings and patient populations. Yet despite our current knowledge of the premium importance of adherence, many of our patients continue to fail therapy due to sub-optimal levels. Our knowledge and understanding are clearly not enough to overcome this challenge. Resources need to be made available and time and money allocated in each and every clinical setting to augment adherence. Health care providers need to be educated in this regard and time must be specifically allocated to direct patient interactions focusing on drug taking behavior. We must consider this an additional "medication" in the patient's combination therapy that requires a designated budget - similar to the other drugs in the regimen.

Presenting author: Jonathan M Schapiro

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1 Stanford University, Tel Aviv, Israel

2002-11-17
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