Pill counts and drug level determinations do not predict therapy failure due to drug resistance in a resource-limited setting
HIV-1 treatment management in resource-limited settings mostly involves clinical and, limited, immunological monitoring. Counselling and pillcounts are used to improve adherence, and are considered a predictor for selection of drug resistance (HIVDR), and hence a tool to guide therapy switching. We...
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Published in | Antiviral therapy Vol. 18; p. A76 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
01.01.2013
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Subjects | |
Online Access | Get full text |
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Summary: | HIV-1 treatment management in resource-limited settings mostly involves clinical and, limited, immunological monitoring. Counselling and pillcounts are used to improve adherence, and are considered a predictor for selection of drug resistance (HIVDR), and hence a tool to guide therapy switching. We assessed the association of pill-counts and drug-levels with actual HIVDR in South African patients. HIVDR-genotyping and drug-level determination were performed on dried blood spots (DBS) collected from 66 patients experiencing virological failure. From DBS, calculated plasma levels [greaterthan]3.0 mg/l for nevirapine and [greaterthan]1.0 mg/l for efavirenz were considered adequate. Lopinavir levels were scored as detectable/not. Structured pill-counts over the year prior to DBS were reported as a percentage and averaged. We have shown that pill-counts and drug-level determination were not associated with predicting the presence of HIVDR. Albeit, pill-counts may be a good method for adherence counselling, they are not sufficient to base decisions on therapy switching. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 content type line 23 ObjectType-Feature-1 |
ISSN: | 1359-6535 |