Limited Patient Adherence to Highly Active Antiretroviral Therapy for HIV-1 Infection in an Observational Cohort Study

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Abstract
TREATMENT OF human immunodeficiency virus type 1 (HIV-1)–infected patients with highly active antiretroviral therapy (HAART) has been shown to be effective with respect to the suppression of plasma HIV-1 RNA below detectable concentrations.1,2 However, the effectiveness of HAART to achieve and sustain viral suppression may be hampered by insufficient patient adherence to the antiretroviral regimen.2-6 Moreover, suboptimal adherence, allowing ongoing viral replication, facilitates the emergence of HIV-1 variants resistant to the drugs being used.2,7 The emergence of drug resistance reduces considerably the treatment options for the individual patient, since cross-resistance exists to a large extent among antiretroviral agents within a therapeutic class.7 Given the potential for transmission of drug-resistant HIV-1, suboptimal adherence may have significant public health implications.8,9

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