Is Nonadherence to ART Associated with Increased Mortality Risk?

Adherence to antiretroviral therapy (ART) is important for achieving virologic suppression and avoiding drug resistance. To investigate the association between suboptimal ART adherence and all-cause mortality, researchers prospectively studied treatment-naive adults who initiated guideline-concordant combination ART in British Columbia between January 2000 and November 2004 (n=903). Medications and access to care were free of charge to all patients through a government program. Adherence (defined as the number of days for which ART was dispensed, divided by the number of follow-up days) was assessed in 6-month increments, with follow-up through November 2005.

Individual adherence declined significantly during treatment, from an average of 79…