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JAC Advance Access first published online on February 6, 2008
This version published online on February 8, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn020
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Review

Forgiveness of non-adherence to HIV-1 antiretroviral therapy

Jonathan Shuter*

Division of Infectious Diseases and AIDS Center, Montefiore Medical Center/Albert Einstein College of Medicine, 111 E 210th Street, Bronx, NY 10467, USA

* Corresponding author. Tel: +1-718-920-7845; Fax: +1-718-405-0610; E-mail: jshuter{at}montefiore.org

Superior adherence to HIV-1 antiretroviral therapy is a mainstay of successful HIV management. Studies performed in the early era of highly active antiretroviral therapy demonstrated the need for ≥95% adherence in order to achieve and sustain viral suppression. High rates of viral suppression have been observed at more moderate levels of adherence with newer antiretroviral regimens. The term ‘forgiveness’ is being used to describe the ability of a regimen to achieve and sustain viral suppression, despite suboptimal adherence. A variety of pharmacological, viral and host properties determine the level of forgiveness of any specific regimen. As the choice of treatment options continues to expand, forgiveness of non-adherence is likely to emerge as an increasingly important factor in therapeutic decision-making.

Key Words: AIDS , treatment , compliance , resistance


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