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首页> 外文期刊>AIDS >Adherence to antiretro viral therapy in resource-limited settings: everything matters
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Adherence to antiretro viral therapy in resource-limited settings: everything matters

机译：在资源有限的环境中坚持抗逆转录病毒疗法：一切都很重要

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摘要

Adherence is one of the major determinants of successful outcomes to antiretroviral therapy (ART) among HIV-infected individuals. In several studies, poor adherence, especially at levels < 95%, has been found to be associated with development of viral resistance, virological failure, progression of disease, and death .Adherence is particularly important in resource-limited settings. This is mainly because of poor access to care and monitoring and limited availability of alternative regimens. Despite numerous studies of outcomes with ART in resource-limited settings, surprisingly few have addressed adherence. Those that have report mostly encouraging results, with adherence rates similar to those observed in developed countries, although notable declines among individuals on more long-term therapy are beginning to be observed . Interesting findings concerning barriers to adherence have also been reported in these studies. More commonly, financial constraints and disruptions in the supply of medications are reported as the major barriers to adherence in resource-limited settings, contrasting significantly with the barriers typically reported in developed countries, such as side effects, stigma, or inconvenience. The findings should raise considerable concern given the uncertainty of long-term donor commitments in resource-limited settings and eventual probability of patients having to pay at least some if not all costs of therapy.
机译：坚持性是感染HIV的个体抗逆转录病毒疗法（ART）成功结果的主要决定因素之一。在几项研究中，人们发现依从性差，尤其是低于95％的依从性与病毒抗药性，病毒学衰竭，疾病进展和死亡有关。在资源有限的环境中，依从性尤其重要。这主要是由于难以获得护理和监测以及替代疗法的可用性有限。尽管在资源有限的情况下对抗逆转录病毒疗法的疗效进行了大量研究，但令人惊讶的是很少有人提到依从性。那些报告的结果大多令人鼓舞的结果，其依从率与发达国家中观察到的相似，尽管开始观察到长期治疗的个体显着下降。这些研究还报道了有关依从性障碍的有趣发现。更为普遍的是，据报道财务拮据和药品供应中断是在资源有限的环境中依从性的主要障碍，这与发达国家通常报道的障碍（例如副作用，污名或不便）形成鲜明对比。鉴于在资源有限的环境中长期捐赠者承诺的不确定性以及患者最终不得不支付至少（如果不是全部）治疗费用的可能性，这一发现应引起人们的极大关注。

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