Effect of patient adherence to antiretroviral therapy on CD4+cell count, HIV-1 RNA, and serum concentrations of tumor necrosis factor and its soluble receptors

被引:12
作者
Girón-González, JA
López-Sánchez, A
Elvira, J
Perez, E
Fernández-Gutiérrez, C
机构
[1] Hosp Univ Puerta del Mar, Fac Med, Serv Med Interne, Unidad Enfermedades Infecc, Cadiz 11009, Spain
[2] Hosp Univ Puerto del Mar, Fac Med, Microbiol Serv, Cadiz, Spain
关键词
D O I
10.1007/s100960000379
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
A 1-year prospective analysis of patient adherence to antiretroviral therapy (zidovudine plus zalcitabine [55 patients] or zidovudine plus zalcitabine plus saquinavir [32 patients]) was performed in human immunodeficiency virus (HIV)infected patients attended at a tertiary care hospital. Adherence to therapy was measured jointly by pharmacy records, patients' self-recording, and an increase in mean corpuscular volume. Likewise, the effects of therapy on clinical parameters, HIV load, CD4+ cell count, and serum levels of tumor necrosis factor alpha (TNF alpha) and its soluble receptors were analyzed. Twenty-seven patients of those on a double-agent regimen and 12 of those on a triple-agent regimen adhered to the treatment, Ten opportunistic events occurred in noncompliant patients versus none in compliant individuals, A significant increase in CD4+ cell count and a decrease in HIV viral load were observed only in patients who adhered to therapy, TNF and its soluble receptors remained elevated at the end of follow-up, even in patients in whom the HIV viral load decreased to < 400 copies/ml. In conclusion, adherence to therapy must be considered a major factor influencing the results of antiretroviral therapy. Although these treatments have been demonstrated to be efficacious, they are not able to normalize the immune activation markers. These data suggest a suboptimal effect of antiretroviral therapy on the eradication of HIV-1.
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页码:852 / 858
页数:7
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