ABSTRACT
Strict adherence to the prescribed drug regimen is one of the most important predictors of success in the antiretroviral therapy of HIV infection. Ideally, patients should learn to optimise their drug adherence before they start antiviral therapy. This study evaluated the predictive role of adherence during the first four weeks of treatment for mid-term treatment outcome. Adherence was evaluated using electronic dosing systems during the first 25 days of therapy in 66 drug-naïve patients starting a new antiretroviral therapy. Treatment outcome (HIV-RNA suppression) was evaluated at week 24 of treatment. Good adherence (>95%doses taken) was associated with better rates of viral suppression (77% vs. 44% Patients with HIV-RNA below 50 copies/ml). Specific education programmes targeted at the achievement of optimal adherence during the first few weeks of therapy might result in better treatment results.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections/drug therapy , Patient Compliance , Adult , Drug Administration Schedule , Drug Monitoring/methods , Forecasting , HumansSubject(s)
AIDS-Related Opportunistic Infections/prevention & control , Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , HIV Infections/immunology , Toxoplasmosis, Cerebral/prevention & control , AIDS-Related Opportunistic Infections/immunology , Adult , Animals , Coccidiostats/therapeutic use , Encephalitis/immunology , Encephalitis/prevention & control , Female , Humans , Toxoplasmosis, Cerebral/immunologySubject(s)
AIDS-Related Opportunistic Infections/diagnosis , Histoplasmosis/diagnosis , Lung Diseases, Fungal/diagnosis , Tonsillitis/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Antifungal Agents/therapeutic use , Diagnosis, Differential , Histoplasmosis/drug therapy , Humans , Itraconazole/therapeutic use , Lung Diseases, Fungal/drug therapy , Male , Middle Aged , Tonsillitis/drug therapyABSTRACT
Ischemia is a rare cause of gastric and duodenal ulcers. For the present study clinical and anatomo-pathologic data from cases published so far and from twelve own patients with ischemic ulcers have been investigated. Histopathology leads to the diagnosis of an ischemic cause with great accuracy. Our results show that ischemic ulcers occur often at gastric sites unusual for a peptic ulcer, and in some cases they look macroscopically different from peptic ulcers. The most common symptom was severe gastrointestinal bleeding. Pain, typical for peptic ulcers, has only rarely been noted by patients. Lethal courses were usually due to gastrointestinal bleeding resistant to therapy. Resection of the involved gastric or duodenal segment or surgical or angiologic reconstruction of the vessels respectively are promising therapeutic means. Without therapeutic intervention very different courses have been observed, ranging from spontaneous healing to fatal gastrointestinal bleeding. The benefit of inhibitors of acid secretion is so far unclear.
