Managing HIV/AIDS Therapy in Treatment-Experienced Patients Can physicians predict non-adherence in their patients?
	Enlarged Version of Graphics Below	Dr. Wohlfeiler (OC): I think clinicians think that they can adequately predict it. But I'm not too sure that we're actually very good at that. I think that you can identify in some patients obvious things that may cause them to be nonadherent. If you've got patients who have major psychiatric issues or they've got major social issues or instability in their life. I think that becomes fairly obvious. But I think that there are a lot of patients that a practitioner will think, yes, this patient's going to be really adherent and I'm not going to have a problem. And you find out that you're wrong. So I don't think that we actually are real great at determining who's going to be adherent to a regimen and who's not. Dr. Bellos (OC): ...I think one of the things that one needs to decide is: Is the patient truly ready for therapy? Because if the patient truly does not have an understanding of what therapy encompasses, and that it's likely to be lifelong, and that there are to be toxicities, those are the patients that are more likely to discontinue therapy because of the toxicities. If the patient understands that there are going to be some toxicities and they are manageable, and if they become unmanageable, we can potentially alter the regimen, then I think that's the patient-and then, once they've embraced that concept, that's the patient you can really look at initiating therapy with. So I'm a little bit reluctant to say that the toxicities are the be all, end all for alteration of therapies, but I think it's important, and I think there are two parameters to consider: as I mentioned, one, the sort of physical manifestations that we see with the lipoatrophy and lipodystrophy, and the other manifestations, which are the metabolic manifestations we see as clinicians.
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