The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App 
Professionals >> Visit The Body PROThe Body en Espanol
Ask the Experts About

Choosing Your MedsChoosing Your Meds
Rollover images to visit our other forums!
Recent AnswersAsk a Question
  • Email Email
  • Glossary Glossary

Nonadherence to HIV Regimen

Oct 5, 2013

I am a pharmacy student with a general question regarding non-adherence with HIV regimens. What is the guideline for re-assessment of therapy following a period of non-adherence? After how many missed doses/days should the patient be re-assessed for potential resistance regarding their therapy? If the patient should be re-assessed, should they stop taking their regimen during this time? Thank you for your time.

Response from Dr. Young

Hello and thanks for posting.

As you point out, adherence is a critically important aspect to care. I'd suggest broadening your view of adherence to not just pill taking, but adherence to medical appointments, refills, etc..

There is no specific guideline for assessment of treatment following interruptions, but clearly a single short interruption (1-4 days, arbitrarily) is not associated with any significant risk of viral breakthrough.

Rather, I look at this as a behavioral pattern- if there are frequent missed doses (and we use the 95 % threshold as a standard bearer), then I will decrease the monitoring frequency, and look for possible viremia.

I don't generally recommend that patients stop their therapies, unless further ongoing adherence is likely to be very poor (and risk generating drug resistance). Indeed, I typically use the opportunity to discuss strategies for enhanced adherence.

Remember that viremia in the setting of very poor adherence may not necessarily mean that resistance or need to change regimens are present, so that obtaining resistance tests are necessary to confirm emerging viral resistance and to guide treatment decisions.

I hope that's helpful, please feel free to write back. BY

Short Term Prednisone for bronchitis and AIDS
Which comes first, a cure or a vaccine ??

  • Email Email
  • Glossary Glossary

 Get Email Notifications When This Forum Updates or Subscribe With RSS



This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint