{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:59:41Z","timestamp":1777453181778,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1056051"],"award-info":[{"award-number":["OPP1056051"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Antiviral Therapy"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Relationships between distinct antiretroviral therapy (ART) adherence patterns and risk of drug resistance are not well understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nested case\u2013control analysis within a longitudinal cohort study of individuals initiating efavirenz-based ART. Primary outcomes of interest, measured at 6 and 12\u00a0months after treatment initiation, were: 1) virologic suppression, 2) virologic failure with resistance, and 3) virologic failure without resistance. Our primary exposure of interest was ART adherence, measured over the 6\u00a0months before each visit with electronic pill monitors, and categorized in three ways: 1) 6\u00a0months average adherence; 2) running adherence, defined as the proportion of days with average adherence over 9\u00a0days of less than or equal to 10%, 20%, and 30%; and 3) number of 3-, 7-, and 28-day treatment gaps in the prior 6\u00a0months<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed data from 166 individuals (107 had virologic failure during observation and 59 had virologic suppression at 6 and 12\u00a0months). Average adherence was higher among those with virologic suppression (median 83%, IQR 58\u201396%) versus those with virologic failure with resistance (median 35%, IQR 20\u201377%, pairwise P &lt; 0.01) and those with virologic failure without resistance (median 21%, IQR 2\u201354%, pairwise P &lt; 0.01). Although treatment gaps generally predicted virologic failure ( P &lt; 0.01), they did not differentiate failure with and without drug resistance ( P &gt; 0.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Average adherence patterns, but not the assessed frequency of treatment gaps, differentiated failure with versus without drug resistance among individuals initiating efavirenz-based ART. Future work should explore adherence-resistance relationships for integrase inhibitor-based regimens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13596535221114822","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T07:17:54Z","timestamp":1666250274000},"page":"135965352211148","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Antiretroviral therapy adherence patterns, virological suppression, and emergence of drug resistance: A nested case\u2013control study from Uganda and South Africa"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3816-6957","authenticated-orcid":false,"given":"Anisha","family":"Tyagi","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Tong","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin J","family":"Rabideau","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts General Hospital, Biostatistics, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahra","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tulio","family":"De Oliveira","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Lessells","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gideon","family":"Amanyire","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute, Durban, South Africa"},{"name":"Global Health Collaborative, Mbarara, Uganda"},{"name":"Makerere University Joint AIDS Program, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Orrell","sequence":"additional","affiliation":[{"name":"Desmond Tutu Health Foundation, Cape Town, South Africa"},{"name":"Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Asiimwe","sequence":"additional","affiliation":[{"name":"Global Health Collaborative, Mbarara, Uganda"},{"name":"Kabwohe Clinical Research Center, Kabwohe, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Chimukangara","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"},{"name":"Centre for the AIDS Programme of Research in South Africa, Durban, South Africa"},{"name":"Critical Care Medicine Department, NIH Clinical Center, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Giandhari","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sureshnee","family":"Pillay","sequence":"additional","affiliation":[{"name":"KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica E","family":"Haberer","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts General Hospital Center for Global Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J","family":"Siedner","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, MA, USA"},{"name":"Harvard Medical School, Boston, MA, USA"},{"name":"Africa Health Research Institute, Durban, South Africa"},{"name":"Massachusetts General Hospital Center for Global Health, Boston, MA, 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