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Highly active antiretroviral therapy (HAART) is an effective treatment for HIV if patients take their drugs as prescribed. Tracking pharmacy claims for reimbursement from insurance companies is one way to measure adherence. It's not ideal, because patients who pick up their drugs at the pharmacy don't necessarily take them, but the method is simple and good enough to give researchers some idea of the link between adherence and viral suppressionsuppression.
Researchers in South Africa used data from pharmacy claims to study HAART based on non-nucleoside reverse transcriptase inhibitors—the first line option in South Africa and elsewhere. They found a clear and linear relation between sustained viral suppression and better adherence to treatment in 2821 men and women being treated for the first time. Viral suppression started to improve once adherence reached 50%. Above this threshold, each 10% increase in adherence was associated with a 10% increase in the proportion of infected people with a viral load below 400 copies of HIV RNA/ml for a median follow-up of two years. Three quarters of the patients who filled all their prescriptions (100% adherence) reached this target (725/997).