  HIV dynamic studies have contributed significantly to the understanding of
HIV pathogenesis and antiviral treatment strategies for AIDS patients.
Establishing the relationship of virologic responses with clinical factors and
covariates during long-term antiretroviral (ARV) therapy is important to the
development of effective treatments. Medication adherence is an important
predictor of the effectiveness of ARV treatment, but an appropriate determinant
of adherence rate based on medication event monitoring system (MEMS) data is
critical to predict virologic outcomes. The primary objective of this paper is
to investigate the effects of a number of summary determinants of MEMS
adherence rates on virologic response measured repeatedly over time in
HIV-infected patients. We developed a mechanism-based differential equation
model with consideration of drug adherence, interacted by virus susceptibility
to drug and baseline characteristics, to characterize the long-term virologic
responses after initiation of therapy. This model fully integrates viral load,
MEMS adherence, drug resistance and baseline covariates into the data analysis.
In this study we employed the proposed model and associated Bayesian nonlinear
mixed-effects modeling approach to assess how to efficiently use the MEMS
adherence data for prediction of virologic response, and to evaluate the
predicting power of each summary metric of the MEMS adherence rates.
