Miller Loren G, Chang Edmond S
UCLA AIDS Institute, Los Angeles, California, USA.
AIDS Patient Care STDS. 2002 Aug;16(8):355-9. doi: 10.1089/10872910260196378.
Poor clinical and virologic response to combination antiretroviral therapy for human immunodeficiency virus (HIV) infection may stem from a variety of factors including poor medication adherence, development of drug-resistant HIV strains, drug interactions, efflux pumps, and unfavorable pharmacokinetics. Diagnosing nonadherence to medication is particularly challenging. We present a case of lack of response to antiretroviral therapy in a patient who denied problems with medication adherence. The patient underwent a variety of objective examinations, all of which suggested poor medication adherence was responsible for his nonresponse to antiretrovirals. An approach to evaluating patients for causes of poor response to antiretroviral therapy and nonadherence and implications for clinical practice are discussed.
人类免疫缺陷病毒（HIV）感染患者对抗逆转录病毒联合疗法的临床和病毒学反应不佳可能源于多种因素，包括药物依从性差、耐药HIV毒株的产生、药物相互作用、外排泵以及不良的药代动力学。诊断药物不依从性极具挑战性。我们报告一例对抗逆转录病毒疗法无反应的患者，该患者否认存在药物依从性问题。该患者接受了各种客观检查，所有检查均提示药物依从性差是其对抗逆转录病毒药物无反应的原因。本文讨论了评估患者对抗逆转录病毒疗法反应不佳及不依从原因的方法及其对临床实践的意义。
