2003
Verona, Italy
Patient adherence and the evolution of resistance to anti-viral agents
Roy Anderson
Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, London, UK
The paper will discuss recent work on the interplay between patient adherence and the evolution of drug resistance in HIV-1 to anti-retrovirals. Mathematical models are described that meld pharmacokinetics, pharmacodynamics, within-host viral population growth and patient adherence. These models are parameterised by reference to defined anti-retrovirals, pathogenesis studies of HIV-1 in cohorts with known dates of seroconversion and data from the use of medication event electronic monitoring (using MEMS caps). Conclusions are drawn about the effects of drug holidays, and periods of poor adherence, on the likelihood of treatment failure.