PURPOSE OF REVIEW Traditional methods to assess antiretroviral adherence, such as self-report, pill counts, and pharmacy refill data, may be inaccurate in determining actual pill-taking to both antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP). HIV viral loads serve as surrogates of adherence on ART, but loss of virologic control may occur well after decreases in adherence and viral loads are not relevant to PrEP. RECENT FINDINGS Pharmacologic measures of adherence, electronic adherence monitors, and ingestible electronic pills all serve as more objective metrics of adherence, surpassing self-report in predicting outcomes. Pharmacologic metrics can identify either recent adherence or cumulative adherence. Recent dosing measures include antiretroviral levels in plasma or urine, as well as emtricitabine-triphosphate in dried blood spots (DBS) for those on tenofovir-emtricitabine-based therapy. A urine tenofovir test has recently been developed into a point-of-care test for bedside adherence monitoring. Cumulative adherence metrics assess adherence over weeks to months and include measurement of tenofovir-diphosphate in peripheral blood mononuclear cells or DBS, as well as ART levels in hair. Electronic adherence monitors and ingestible electronic pills can track pill bottle openings or medication ingestion, respectively. New and objective approaches in adherence monitoring can be used to detect nonadherence prior to loss of prevention efficacy or virologic control with PrEP or ART, respectively.

中文翻译：

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客观测量抗逆转录病毒药物依从性和推动依从干预的方法。

审查的目的 评估抗逆转录病毒治疗依从性的传统方法，例如自我报告、药丸计数和药房补充数据，在确定抗逆转录病毒治疗 (ART) 或暴露前预防 (PrEP) 的实际服药情况时可能不准确。HIV 病毒载量可作为 ART 依从性的替代指标，但在依从性下降后很长时间可能会发生病毒学控制的丧失，并且病毒载量与 PrEP 无关。最近的发现 依从性的药理学测量、电子依从性监测仪和可摄入电子药丸都可以作为更客观的依从性指标，在预测结果方面超越自我报告。药理学指标可以识别最近的依从性或累积的依从性。最近的剂量测量包括血浆或尿液中的抗逆转录病毒水平，以及针对接受替诺福韦-恩曲他滨治疗的患者的干血斑（DBS）中的恩曲他滨-三磷酸盐水平。尿液替诺福韦测试最近已发展成为用于床边依从性监测的床边护理测试。累积依从性指标评估数周至数月的依从性，包括测量外周血单核细胞或 DBS 中的替诺福韦二磷酸盐，以及头发中的 ART 水平。电子依从性监测器和可摄入电子药丸可以分别跟踪药瓶开口或药物摄入情况。依从性监测的新的客观方法可用于在 PrEP 或 ART 的预防效力或病毒学控制丧失之前检测不依从性。