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20 30 40 50 60 70 80 90 100 0 4 8 16 32 48 64 72 80 88 Week Patients 400 copies/mL, % DOT SAT (ACTG) Fischl, et al. Abst. 528, 8th CROI, 2023. *3 drug regimen that included efavirenz statistically equivalent to DOT, 94% vs. 100% 400 copies/mL Directly Observed Therapy (DOT) vs SelfAdministered Therapy (SAT)* “ What is Your Preferred Schedule For Taking HIV Medications?” 0 20 40 60 80 100 4 pills once during the day (either morning or evening) 1 pill in the morning and 2 pills at night 1 pill in the morning and 4 pills at night 73% 18% 9% Regimen Characteristics The AWARE Talk Radio Poll。 The AIDS Talk Radio Project in conjunction with The Core Center。 Howard Brown Health Center。133:21. Greatest danger zone for developing resistance ? Data from the “ IDV era” demonstrates the impact of even minor variations in adherence ? ?95% adherence is required for optimal virologic suppression 依從性不好所產(chǎn)生的后果和影響依從性的因素 ? 對 HAART沒有很好依從性的病人,很容易發(fā)生病毒學和免疫學的治療失敗,并且容易產(chǎn)生抗藥性、變異,而這種變異將限制以后治療方案的選擇 ? 依從性不佳是治療失敗最常見的原因之一,造成治療依從性下降的原因有很多 ? 復雜的治療方案是依從性不佳的一個重要原因,包括服藥量過多,服藥次數(shù)過多,服藥時間不便,飲食限制或其他原因。 依從性與病毒學治療失敗的關(guān)系 MEMS = Medication Event