ArticleInternational health2011
Suboptimal adherence associated with virological failure and resistance mutations to first-line highly active antiretroviral therapy (HAART) in Bangalore, India.
Article in International health, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Pooled it
- Pooled it
- Trial
- Trial
- Sustained Effect of a Community-based Behavioral and Nutrition Intervention on HIV-related Outcomes Among Women Living With HIV in Rural India: A Quasi-experimental Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Randomized controlled trial of a community-based intervention on HIV and nutritional outcomes at 6 months among women living with HIV/AIDS in rural India.AIDS (London, England) · 2018Trial
- Effect of mobile telephone reminders on treatment outcome in HIV: evidence from a randomised controlled trial in India.BMJ (Clinical research ed.) · 2014Trial
- Treatment outcomes in palliative care: the TOPCare study. A mixed methods phase III randomised controlled trial to assess the effectiveness of a nurse-led palliative care intervention for HIV positive patients on antiretroviral therapy.BMC infectious diseases · 2012Trial
- Effect of adherence as measured by MEMS, ritonavir boosting, and CYP3A5 genotype on atazanavir pharmacokinetics in treatment-naive HIV-infected patients.Clinical pharmacology and therapeutics · 2012Trial
- Past Achievements, Present Gaps, and Future Priorities in Pneumocystis jirovecii Research: A Global Bibliometric Analysis.Pathogens (Basel, Switzerland) · 2026Review
- Attitudes and Barriers Toward Antiretroviral Therapeutic Drug Monitoring Among Infectious Disease Providers.Medicina (Kaunas, Lithuania) · 2025Article
- Review
- Is self-reported adherence a valid measure of glycaemic control among people living with diabetes in rural India? A cross-sectional analysis.Primary care diabetes · 2022Article
- Relationship Dynamics are Associated with Self-Reported Adherence but not an Objective Adherence Measure in Malawi.AIDS and behavior · 2022Article
- Developing Reporting Guidelines for Studies of HIV Drug Resistance Prevalence: Protocol for a Mixed Methods Study.JMIR research protocols · 2022Article
- Mental health of women living with HIV and its impact on child development in Andhra Pradesh, India.Vulnerable children and youth studies · 2021Article
- HIV Drug Resistance in Children and Adolescents: Always a Challenge?Current epidemiology reports · 2021Review
- ART Adherence, Resistance, and Long-term HIV Viral Suppression in Postpartum Women.Open forum infectious diseases · 2020Article
- A Behavioral Adherence Intervention Improves Rates of Viral Suppression Among Adherence-Challenged People Living with HIV in South India.AIDS and behavior · 2020Article
- Cost-effectiveness of a novel strategy of HIV/AIDS care in Armed Forces: A stochastic model with Monte Carlo simulation.Medical journal, Armed Forces India · 2020Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
This study was conducted to examine the relationship between adherence, viral load (VL) and resistance among outpatients receiving highly active antiretroviral therapy (HAART) in Bangalore, India. In total, 552 outpatients were recruited and VL testing was conducted for all study participants. HIV-1 genotypic resistance testing was performed for 92 participants with a VL ≥ 1000 copies/ml. Interpretation of resistance mutations was performed according to the Stanford database. Past-month adherence and treatment interruptions for >48 h were assessed via self-report. At baseline, 34 participants (6%) reported <95% past-month adherence and 110 (20%) reported a history of >48 h treatment interruptions. Combining the two adherence measures, 22% of participants were classified as 'suboptimally adherent'. In total, 24% of study participants (n = 132) had a detectable VL. Among the 92 samples sent for resistance testing, 68% had at least one nucleoside reverse transcriptase inhibitor (NRTI) mutation, with M184V being the most common (62%) and with 48% having thymidine analogue mutations. Moreover, 72% had at least one non-nucleoside reverse transcriptase inhibitor (NNRTI) mutation and 23% had three or more NNRTI mutations. Both adherence measures were significantly associated with VL (P < 0.001). Suboptimal adherence was significantly associated with resistance mutations (P < 0.02). The findings illustrate for the first time the strong association between suboptimal adherence, treatment failure and drug resistance to first-line HAART in India. The predictive value of standard adherence measures was improved by including treatment interruption data. The observed mutations can jeopardise future treatment options, especially in light of limited access to second-line treatments. To develop effective adherence interventions, research is needed to examine culturally-specific reasons for treatment interruptions.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.