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Monitoring whether patients take medicines can help anticipate HIV treatment failure in Africa
Date:5/19/2008

Adherence shows advantages over T-cell counts for monitoring HIV treatment

Information on how reliably people take their anti-HIV medicines can help identify those whose treatment will succeed or fail. Monitoring this information, which can be obtained directly from pharmacy records, works at least as well as performing blood tests that track the medicines effect on the immune system, according to research published in PLoS Medicine by Gregory Bisson, Jean Nachega and colleagues at the University of Pennsylvania, Johns Hopkins Bloomberg School of Public Health, and the University of Cape Town.

Adherence, or taking medications exactly as prescribed, has long been known to be a key factor in the success of HIV treatment. In developed countries, success has been defined using blood tests to measure how well medications suppress the AIDS virus. These so-called viral load tests are often difficult to provide in developing countries, so alternatives are used, including CD4 T-cell counts, which indicate how well the immune system is responding to treatment. However, falling CD4 counts tend to indicate treatment failure only after the fact, often at a point when the virus has developed resistance and the patients medications must be changed, typically to drugs that are more costly or difficult to take.

Working with an insurance plan that covers HIV treatment in 9 African countries, the researchers in this study calculated patient adherence from monthly claims for AIDS medicines actually dispensed by pharmacies, in proportion to the number of months that medicines were prescribed to the patient. Statistically comparing these adherence measures to CD4 test results in more than 1800 patients whose viral load results were available, they found that adherence was more accurate than CD4 counts in identifying individuals who went on to experience treatment failure over 6 months and 12 months of treatment.

These findings suggest tha
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Contact: Andrew Hyde
press@plos.org
01-223-463-330
Public Library of Science
Source:Eurekalert

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