Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - July 30, 2003
Resistance: Taking between 60% and 90% of prescribed anti-retrovirals is the surest way to acquire resistance to the drugs, according to the results of a clinical study presented at a recent conference on HIV pathogenesis and treatment in Paris.
The researchers say that 90% adherence is the equivalent of missing no more than five doses in four weeks of a twice-daily regimen, or three doses a month of a once-daily drug.
But a high viral load and, to a lesser extent, a low CD4 cell count were also found to have a lesser bearing on the emergence of resistance. That suggests anti-retroviral therapy does not completely stop viral replication and therefore the emergence of resistance.
A significant minority of those who adhered to anti-retroviral therapy more than 95% of the time were found to have sub-optimal levels of drugs in blood samples taken after therapy began, suggesting that drug interactions or absorption also play a part in the emergence of resistance.
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