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Editor's Correspondence
September 28, 1998

Adherence and Effectiveness of Highly Active Antiretroviral Therapy

Arch Intern Med. 1998;158(17):1953. doi:

Adherence to therapy is of the utmost importance in human immunodeficiency virus (HIV) infection owing to the high level of viral replication. Antiretroviral pressure invariably causes the selection of resistant mutants and possible treatment failure. Moreover, adherence to highly active antiretroviral therapy, not viremia, is the most important factor in determining the number of CD4 cells.1 To what extent adherence is necessary for obtaining full benefit and preventing resistance is not known and may vary by agent, stage of disease, viral load, and previous therapy.2

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