Saberi P, Caswell N, Amodio-Groton M, Alpert P
Department of Family and Community Medicine, University of California San Francisco, US.
AIDS Care. 2008 Jul;20(6):741-5. doi: 10.1080/09540120701694006.
The objective of this study was to determine if a lower rate of adherence (<95%) is sufficient to maintain HIV viral suppression in patients on an efavirenz-based regimen. This study was a retrospective review of pharmacy refill records at an HIV specialty pharmacy at Montefiore Medical Center's outpatient clinic. Data from 151 HIV-positive patients on an efavirenz-based regimen with at least one undetectable viral load (HIV RNA < 400 copies/mL) from December 2003 through March 2005 were reviewed. Adherence was calculated based on the formula: [(pills dispensed/pills prescribed per day/days between refills)x100%]. Calculated adherence for each time-period was correlated to the respective HIV-RNA value for that period. Of 151 patients, viral suppression was maintained in greater than 80% of time periods for adherence rates as low as 85-90%. The periods with 75-80% adherence also had higher than 85% suppression. Rates of suppression began to fall when adherence decreased to < 75%. In conclusion, lower adherence rates (<95%) on an efavirenz-based regimen were more successful in maintaining viral suppression than previously found with unboosted protease inhibitor-based regimens.
本研究的目的是确定较低的依从率（<95%）是否足以使接受依非韦伦治疗方案的患者维持HIV病毒抑制状态。本研究是对蒙特菲奥里医疗中心门诊的一家HIV专科药房的药房配药记录进行的回顾性分析。回顾了2003年12月至2005年3月期间151例接受依非韦伦治疗方案且至少有一次病毒载量检测不到（HIV RNA<400拷贝/mL）的HIV阳性患者的数据。依从性根据以下公式计算：[（配药量/每日处方量/两次配药间隔天数）×100%]。计算每个时间段的依从性，并将其与该时间段各自的HIV-RNA值相关联。在151例患者中，对于低至85%-90%的依从率，超过80%的时间段维持了病毒抑制。依从率为75%-80%的时间段也有超过85%的抑制率。当依从性降至<75%时，抑制率开始下降。总之，基于依非韦伦的治疗方案中较低的依从率（<95%）在维持病毒抑制方面比以前基于未增强蛋白酶抑制剂的治疗方案更成功。
