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Adherence to therapy is of the utmost importance in human immunodeficiency virus (HIV) infection owing to the high level of viral replication. Antiretroviral pressure invariably causes the selection of resistant mutants and possible treatment failure. Moreover, adherence to highly active antiretroviral therapy, not viremia, is the most important factor in determining the number of CD4 cells.¹ To what extent adherence is necessary for obtaining full benefit and preventing resistance is not known and may vary by agent, stage of disease, viral load, and previous therapy.²

We recently analyzed the relationship between adherence and prescribed antiretroviral therapy on the ability of the therapy to attain an undetectable viral load at 24 weeks of treatment in an observational cohort study of nonselected patients treated with zidovudine, 300 mg 2 times per day, lamivudine, 150 mg 2 times per day, and indinavir, 800 mg 3 times per day, at a 450-bed university hospital . . . [Full Text of this Article]

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