Department of Infectious Diseases, Centre Hospitalier Universitaire, Tours, France.
J Acquir Immune Defic Syndr. 2012 Nov 1;61(3):265-9. doi: 10.1097/QAI.0b013e31826cc592.
Adherence patterns and their influence on virologic outcome are well characterized for protease inhibitor (PI)- and non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. We aimed to determine how patterns of adherence to raltegravir influence the risk of virological failure. We conducted a prospective multicenter cohort following 81 HIV-infected antiretroviral-naive or experienced subjects receiving or starting twice-a-day raltegravir-based antiretroviral therapy. Their adherence patterns were monitored using the Medication Events Monitoring System. During follow-up (188 days, ±77), 12 (15%) of 81 subjects experienced virological failure. Longer treatment interruption [adjusted odds ratio per 24-hour increase: 2.4; 95% confidence interval: 1.2 to 6.9; P < 0.02] and average adherence (odds ratio per 5% increase: 0.68; 95% confidence interval: 0.46 to 1.00, P < 0.05) were both independently associated with virological failure controlling for prior duration of viral suppression. Timely interdose intervals and high levels of adherence to raltegravir are both necessary to control HIV replication.
基于蛋白酶抑制剂（PI）和非核苷类逆转录酶抑制剂（NNRTI）的治疗方案，药物依从性模式及其对病毒学结果的影响已得到很好的描述。我们旨在确定利托那韦的依从模式如何影响病毒学失败的风险。我们对 81 名接受或开始每日两次利托那韦为基础的抗逆转录病毒治疗的抗逆转录病毒初治或经验丰富的 HIV 感染患者进行了前瞻性多中心队列研究。他们的依从模式通过药物事件监测系统进行监测。在随访期间（188 天，±77），81 名受试者中有 12 名（15%）发生病毒学失败。治疗中断时间较长（每增加 24 小时校正比值比：2.4；95%置信区间：1.2 至 6.9；P < 0.02）和平均依从性（每增加 5%的比值比：0.68；95%置信区间：0.46 至 1.00，P < 0.05）与病毒学失败相关，同时控制了先前病毒抑制的持续时间。及时的间剂量间隔和高水平的利托那韦依从性对于控制 HIV 复制都是必要的。
