A combination of poor adherence and a low baseline susceptibility score is highly predictive for HAART failure

Van Vaerenbergh, Kristien; De Geest, Sabina; Derdelinckx, Inge; Bobbaers, Herman; Carbonez, An; Deschamps, Ann; De Graeve, Veerle; De Saar, Veerle; Ceunen, Helga; De Smet, Koen; Maes, Bart; Peetermans, Willy; Schrooten, Yoeri; Desmyter, Jan; De Clercq, Erik; Van Ranst, Marc; Van Wijngaerden, Eric; Vandamme, Anne-Mieke

doi:10.1177/095632020201300404

A combination of poor adherence and a low baseline susceptibility score is highly predictive for HAART failure

Author:

Van Vaerenbergh, Kristien

De Geest, Sabina ; Derdelinckx, Inge ; Bobbaers, Herman ; Carbonez, An ; Deschamps, Ann ; De Graeve, Veerle ; De Saar, Veerle ; Ceunen, Helga ; De Smet, Koen ; Maes, Bart ; Peetermans, Willy ; Schrooten, Yoeri ; Desmyter, Jan ; De Clercq, Erik ; Van Ranst, Marc ; Van Wijngaerden, Eric ; Vandamme, Anne-Mieke

Keywords:

adherence, HIV-1, HAART, genotypic drug resistance, viral load, Treatment Failure, Adult, Algorithms, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Drug Resistance, Viral, Electronics, Genotype, HIV Infections, Humans, Logistic Models, Male, Middle Aged, Patient Compliance, Predictive Value of Tests, RNA, Viral, Treatment Refusal, Viral Load, 0304 Medicinal and Biomolecular Chemistry, 0601 Biochemistry and Cell Biology, 1117 Public Health and Health Services, Virology, 3404 Medicinal and biomolecular chemistry

Abstract:

The relationship between adherence, virological response to highly active antiretroviral therapy (HAART) and the presence and development of genotypic resistance was assessed in 41 HIV-infected patients on HAART. Four adherence parameters (drug taking adherence, dosing adherence, timing adherence and drug holidays) were scored prospectively using electronic event monitoring. Genotypic resistance at baseline and after therapy failure was scored retrospectively and a genotype-based susceptibility score was calculated. Overall median adherence rates were high. All adherence parameters were better in virological responders (n=31) compared to non-responders (n=10), drug taking adherence and number of drug holidays being significantly different. Responders had a significantly higher susceptibility score. Stepwise logistic regression showed that the number of drug holidays and a low susceptibility score were highly predictive for therapy failure. Despite the presence of a limited number of baseline resistance mutations, perfectly adherent patients can control virus replication for a prolonged period.