Do benefits of earlier antiretroviral treatment initiation outweigh harms for individuals at risk for poor adherence?

Abstract

Clinicians may defer antiretroviral treatment for patients with suboptimal adherence. We used a validated computer simulation of HIV disease progression to compare alternative treatment thresholds for patients with suboptimal adherence. Earlier treatment increased life expectancy across a wide adherence range(50%-100% of doses taken). Delaying treatment for patients with suboptimal adherence may not always be appropriate. © 2009 by the Infectious Diseases Society of America. All rights reserved.