HIV-infected patients receiving lopinavir/ritonavir-based antiretroviral therapy achieve high rates of virologic suppression despite adherence rates less than 95%

Jonathan Shuter, Julie A. Sarlo, Tina J. Kanmaz, Richard A. Rode, Barry S. Zingman

Research output: Contribution to journalArticle

122 Scopus citations

Abstract

BACKGROUND: The observation that extremely high levels of medication adherence are required to achieve complete virologic suppression is based largely on studies of treatment-experienced patients receiving HIV protease inhibitor (PI)-based therapy without ritonavir boosting. This study aims to define the level of adherence needed to achieve virologic suppression in patients receiving boosted PI-based highly active antiretroviral therapy (HAART) with lopinavir/ritonavir. METHODS: HIV-infected adults receiving a regimen containing lopinavir/ritonavir were recruited into a prospective, observational study of the relation between adherence to lopinavir/ritonavir and virologic outcomes. Adherence was measured using the Medication Event Monitoring System (MEMS; Aardex, Union City, CA). HIV-1 viral load (VL) was measured at week 24. RESULTS: The final study population contained 64 subjects. Eighty percent had AIDS, 97% received lopinavir/ritonavir before enrollment, and most had more than 7 years of HAART experience. Mean adherence overall was 73%. Eighty percent and 59% achieved a VL <400 copies/mL and a VL <75 copies/mL, respectively. Mean adherence was 75% in those achieving a VL <75 copies/mL. High rates of virologic suppression were observed in all adherence quartiles, including the lowest quartile (range of adherence: 23.5%-53.3%). CONCLUSIONS: Moderate levels of adherence can lead to virologic suppression in most patients taking lopinavir/ritonavir-based HAART.

Original languageEnglish (US)
Pages (from-to)4-8
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Volume45
Issue number1
DOIs
StatePublished - May 1 2007

Keywords

  • AIDS
  • Adherence
  • HIV
  • Lopinavir
  • Medication Event Monitoring System

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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