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

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118 Citations (Scopus)

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 2007

Fingerprint

Lopinavir
Ritonavir
HIV
Viral Load
Highly Active Antiretroviral Therapy
Therapeutics
Micro-Electrical-Mechanical Systems
HIV Protease Inhibitors
Medication Adherence
Protease Inhibitors
Observational Studies
HIV-1
Acquired Immunodeficiency Syndrome
Prospective Studies
Population

Keywords

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

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

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title = "HIV-infected patients receiving lopinavir/ritonavir-based antiretroviral therapy achieve high rates of virologic suppression despite adherence rates less than 95{\%}",
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.",
keywords = "Adherence, AIDS, HIV, Lopinavir, Medication Event Monitoring System",
author = "Jonathan Shuter and Sarlo, {Julie A.} and Kanmaz, {Tina J.} and Rode, {Richard A.} and Zingman, {Barry S.}",
year = "2007",
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T1 - HIV-infected patients receiving lopinavir/ritonavir-based antiretroviral therapy achieve high rates of virologic suppression despite adherence rates less than 95%

AU - Shuter, Jonathan

AU - Sarlo, Julie A.

AU - Kanmaz, Tina J.

AU - Rode, Richard A.

AU - Zingman, Barry S.

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N2 - 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.

AB - 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.

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