DUTCH STUDY FINDS AIDS DRUGS MISUSED

Reuters 10 Sept. 2001

Chicago -- Only about half of HIV-infected patients in a study published Sunday were found to be taking their antiretroviral drugs according to directions, opening the way to treatment failure and possible drug resistance.

Such drugs are prescribed on a complicated schedule, often requiring multiple doses two to four times a day, sometimes with dietary provisions.

But the report, by Pythia T. Nieuwkerk and colleagues of the Academic Medical Center, Amsterdam, the Netherlands, found that only 47% of 224 patients questioned during 1998 and 1999 reported that they took all their anti-HIV drugs all the time as directed. Patients who reported deviating from their prescribed regimens were also more likely to have higher levels of the virus.

"The finding that a substantial number of patients did not succeed in taking (the drugs) as prescribed illustrates the difficulty of consistently taking antiretroviral medication according to all requirements,'' said the report, published in the Sept. 10 issue of the Archives of Internal Medicine.

"To date, it is not known what level of adherence to (the drugs) is precisely needed to prevent viral rebound and the emergence of drug- resistant virus variants,'' it added.

The researchers said the consequences of not following directions will vary with the medications involved and urged doctors to consider a patient's ability to follow the prescribed course when choosing among various treatments.

The study said following instructions is essential in suppressing the virus that causes AIDS (news - web sites) and in preventing the virus from developing resistance to the drugs.

Because HIV-infected people could transmit a drug-resistant virus, the matter has "significant public health implications,'' the report added.

The study was financed by the AIDS Fund, Amsterdam, and by a grant from the Health Insurance Fund Council, Amstelveen, the Netherlands.