Division of General Medicine, Department of Medicine, Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin, Houston, TX 77030, USA.
Curr HIV/AIDS Rep. 2010 Nov;7(4):245-52. doi: 10.1007/s11904-010-0056-2.
HIV treatment guidelines state that patients' readiness should be assessed before initiating highly active antiretroviral therapy (HAART) to assure adherence. None of the guidelines provide a way to measure readiness. Therefore, this article sought to review the literature on readiness to determine if there was a viable predictor of adherence. Twenty-seven articles were reviewed. Nine described studies that examined the relationship between a measure of readiness and HAART adherence. No readiness measure demonstrated clinical utility as a predictor of adherence. Study flaws included small sample sizes (only one study >100 patients), short follow-up periods (all ≤1 year and six were ≤5 months, four ≤1 month), measures of readiness that related poorly to adherence, and inconsistent adherence measures (eight different measures were used by the researchers). Neither the guidelines nor the literature will help clinicians judge who should initiate HAART and who should delay treatment.
HIV 治疗指南指出，在开始高效抗逆转录病毒治疗（HAART）之前，应评估患者的准备情况，以确保其依从性。但这些指南均未提供衡量准备情况的方法。因此，本文旨在回顾有关准备情况的文献，以确定是否存在可预测依从性的可行指标。共回顾了 27 篇文章。其中 9 篇描述了研究准备情况与 HAART 依从性之间关系的研究。没有任何准备指标可作为依从性的预测指标具有临床实用性。研究缺陷包括样本量小（只有一项研究的患者人数超过 100），随访时间短（所有研究均≤1 年，6 项研究≤5 个月，4 项研究≤1 个月），与依从性相关性差的准备情况衡量标准，以及不一致的依从性衡量标准（研究人员使用了 8 种不同的衡量标准）。指南和文献都无法帮助临床医生判断谁应该开始接受 HAART 治疗，谁应该延迟治疗。
