人类免疫缺陷病毒感染者抗病毒治疗服药依从性监测与管理

Monitoring and Managing the Adherence to Antiretroviral Therapy in Patients with Human Immunodeficiency Virus Infection

高效抗反转录病毒治疗大大降低了人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者的病死率,使HIV感染者可获得长期存活。服药依从性是实现病毒抑制、延缓疾病进展的关键因素之一。目前依从性的测量方法可分为间接和直接测量两种。影响依从性的因素大致可分为个体水平因素、药物治疗方案因素、人际关系问题和结构性问题4大类。可提高依从性的方法有:短消息提醒、指导治疗及制定计划、实时依从性监测和应用长效抗病毒药物制剂等。虽然已有较多相关依从性的研究,获得可推广的行之有效的依从性监测及提高手段仍存在较大挑战。

Highly effective antiretroviral therapy(ART)can greatly reduce the fatality rate in patients with human immunodeficiency virus infection and enable them to achieve long-term survival.Medication adherence is one of the key factors to achieve viral suppression and delay disease progression.Current methods of measuring adherence can be divided into indirect and direct methods.The factors affecting adherence can be roughly divided into four categories:individual levels,drug treatment programs,interpersonal relationship problems,and structural problems.Strategies to improve adherence include short message alert,treatment guidance and planning,real-time adherence monitoring,and application of long-acting antiviral agents.Although there have been many studies on adherence,there are still major challenges in obtaining effective and scalable adherence monitoring and improvement tools.