Not All Missed Doses Are the Same: Sustained NNRTI Treatment Interruptions Predict HIV Rebound at Low-to-Moderate Adherence Levels
2008

Impact of Missed Doses on HIV Treatment

Sample size: 72 publication 10 minutes Evidence: moderate

Author Information

Author(s): Parienti Jean-Jacques, Das-Douglas Moupali, Massari Véronique, Guzman David, Deeks Steven G., Verdon Renaud, Bangsberg David R.

Primary Institution: Côte de Nacre University Hospital, Caen, France

Hypothesis

Patterns of adherence in addition to average adherence may be an important determinant of incomplete viral suppression.

Conclusion

Sustained treatment interruption may pose a greater risk of virologic rebound on NNRTI therapy than the same number of interspersed missed doses at low-to-moderate adherence.

Supporting Evidence

  • Each 10% increase in average adherence decreased the risk of virologic rebound.
  • Sustained treatment interruptions were more closely associated with virologic rebound than interspersed missed doses.
  • A treatment interruption of 15 days was associated with a 50% probability of virologic rebound.

Takeaway

If people with HIV miss their medicine for a long time, it can make their illness worse, even if they usually take it most of the time.

Methodology

The study analyzed data from NNRTI-treated individuals who achieved initial virologic response, focusing on adherence patterns and virologic rebound.

Potential Biases

The study may not represent all patients due to the specific cohorts selected.

Limitations

The number of events was small, and the observational design does not demonstrate causality.

Participant Demographics

Participants included individuals from diverse socio-economic and ethnic backgrounds in France and North America.

Statistical Information

P-Value

<0.002

Confidence Interval

[0.37, 0.81]

Statistical Significance

p<0.002

Digital Object Identifier (DOI)

10.1371/journal.pone.0002783

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