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      Measurement complexity of adherence to medication

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          Correlation between lamivudine plasma concentrations and patient self-reported adherence to antiretroviral treatment in experienced HIV patients

          Background Adherence to antiretroviral treatment (ART) is important to achieve treatment success in human immunodeficiency virus (HIV)-infected patients. Most HIV clinics apply the patient self-report (PSR) method. However, the reliability of this method in experienced HIV patients remains questionable. Purpose To validate the PSR method for measuring adherence to ART using lamivudine (3TC) plasma concentrations in experienced HIV patients. Methods The study was conducted in Dar Es Salaam and involved 220 patients who were receiving ART services at HIV clinics for more than 12 months. Self-reported adherence information to ART was obtained on the day of HIV clinic visit. The patients were asked to mention the number of doses missed within the past 7 days. In addition, blood samples (2 mL) were collected from each patient on the same day. The blood samples were determined for 3TC plasma concentrations. The target 3TC plasma concentration as indicator concentration for adherent patients was determined in 20 patients who took their evening dose of antiretrovirals under supervision. The blood from these patients was drawn 3 hours after drug administration. Results Complete drug levels of 3TC and self-reported adherence data was obtained in 200 treatment-experienced HIV patients. Lamivudine plasma concentrations obtained in these patients ranged between 0.02–17.36 μg/mL. The mean time from dose administration to blood drawing was 3.1 ± 1.2 hours with coefficient of variation >39%. The mean 3TC plasma concentration obtained in 20 patients who took their antiretroviral dose under supervision was found to be 0.67 ± 0.46 μg/mL, range 0.25–2.33 μg/mL. As many as 82.5% of experienced HIV patients had PSRs in agreement with their 3TC plasma concentrations. Conclusion PSR adherence is still a valid method for ascertaining adherence to ART in treatment-experienced HIV patients.
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            Desafios da adesão ao tratamento de pessoas vivendo com HIV/Aids no Brasil [Challenges of treatment adherence by people living with HIV/AIDS in Brazil]

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              Steady-state pharmacokinetics of lamivudine once-daily versus twice-daily dosing in Chinese HIV-infected patients.

              The present study aimed to compare the pharmacokinetics of lamivudine in 300 mg once-daily and 150 mg twice-daily dosing regimens in HIV-infected Chinese patients.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2012
                2012
                02 April 2012
                : 8
                : 169-171
                Affiliations
                Master Program in Health Sciences, University of Southern Santa Catarina (Unisul) Tubarão, Santa Catarina, Brazil
                Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
                Author notes
                Correspondence: Dayani Galato, Pharmacy School and Master of Health Science, University of Southern Santa Catarina, Avenida José Acácio Moreira, 787, Bairro Dehon, Tubarão, Santa Catarina, Brazil, Cep 88704-900, Tel +55 48 3621 3363, Fax +55 48 3621 3365, Email dayani.galato@ 123456unisul.br
                Correspondence: Omary Minzi, Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, PO Box 65013, Dar Es Salaam, Tanzania, Email minziobejayesu@ 123456gmail.com
                Article
                tcrm-8-169
                10.2147/TCRM.S30849
                3333465
                22547935
                1ee10947-6cb4-4855-926b-a96a2ddf0b0a
                © 2012 Galato et al, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

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