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AIDS Behav. 2010 Aug;14(4):785-93. doi: 10.1007/s10461-009-9555-9. Epub 2009 Apr 8.

Importance of dose timing to achieving undetectable viral loads.

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Center for International Health and Development, Boston University of Public Health, Boston, MA 02118, USA.


Little is known about the importance of dose timing to successful antiretroviral therapy (ART). In a cohort comprised of Chinese HIV/AIDS patients, we measured adherence among subjects for 6 months using three methods in parallel: self-report using a visual analog scale (SR-VAS), pill count, and electronic drug monitors (EDM). We calculated two adherence metrics using the EDM data. The first metric used the proportion of doses taken; the second metric credited doses as adherent only if taken within a 1-h window of a pre-specified dose time (EDM 'proportion taken within dose time'). Of the adherence measures, EDM had the strongest associations with viral suppression. Of the two EDM metrics, incorporating dose timing had a stronger association with viral suppression. We conclude that dose timing is also an important determinant of successful ART, and should be considered as an additional dimension to overall adherence.

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