Adherence Profiles and Therapeutic Responses of Treatment-Naive HIV-Infected Patients Starting Boosted Atazanavir-Based Therapy in

The adherence profile of HIV-infected patients predicts the therapeutic outcome, in particular during the early phase of antiret-roviral therapy (ART). We conducted a prospective observational multicenter trial monitoring adherence and virological and immunological parameters over the initial 6 months of treatment. Thirty-five subjects were starting a treatment regimen includ-ing atazanavir, ritonavir, and emtricitabine-tenofovir. Adherence was assessed using self-completed questionnaires, announced pill counts, and the medication event monitoring system (MEMS) for each drug. Three MEMSmeasures were defined: the per-centages of doses taken, days with the correct dosing, and doses taken on time (3 h). Dynamic virological suppression (DVS) was defined as a reduction in the plasma HIV-RNA level of>1 log10 per month or<40 copies/ml. The cumulative treatment time was 5,526 days. A high level of adherence was observed. TheMEMS-defined adherence for correct dosing (0.68 % per 4-week period, P< 0.03) and timing compliance (1.60 % per 4-week period, P< 0.003) decreased significantly over time. TheMEMS-defined adherence data were concordant with the pill counts during the trial but not with the data from the questionnaires. Th