Long-term utility of measuring adherence by self-report compared with pharmacy record in a routine clinic setting.

OBJECTIVES: To compare long-term adherence to antiretroviral therapy in an HIV service, as measured by self-report and by pharmacy records. To determine the level of adherence by each measure required to suppress viral load in a majority of patients. METHODS: The percentage of prescribed doses taken was calculated from (a) the number of missed doses in the previous 28 days reported by patients in a questionnaire at each clinic visit, and (b) pharmacy dispensing records. These were compared with each other and with HIV viral load data. RESULTS: Mean adherence was 96.2% by pharmacy record over 44 months and 98.6% by self-report over 25 months. The two methods correlated with each other (P<0.001) and the proportion of patients with viral load <400 HIV-1 RNA copies/mL increased with adherence as measured by self-report (P=0.001) and pharmacy record (P=0.004). Fewer than 60% of patients always had viral loads <400 copies/mL if adherence fell below 95% (pharmacy record) or 97% (self-report). Adherence was higher for once-daily than for twice-daily therapy (by pharmacy record: 97.2% vs. 96.0%; P<0.001). Adherence by both measures increased over time. CONCLUSIONS: Self-reported antiretroviral adherence correlates with pharmacy dispensing records and predicts suppression of viral load at levels >or=97%. It is practical to adopt this into routine HIV clinical care.

Sex pheromone of the european sunflower moth,Homoeosoma nebulellum (Den. & Schiff.) (Lepidoptera: Pyralidae).

Four components, (Z)-9-tetradecenal (8.6%), (Z,E)-9,12-tetradecadienal (4.8%), (Z)-11-hexadecenal (49.5%), and (Z)-13-octadecenal (37.1%), were identified in extracts of female pheromone glands of the European sunflower moth,Homoeosoma nebulellum (Lepidoptera: Pyralidae) using GC and GC-MS analyses. EAG and single-cell recordings of male antennal receptors gave strong evidence for (Z,E)-9,12-tetradecadienal as the antennal key compound of sex pheromone detection in this species. This result was confirmed by field trapping; removal of (Z,E)-9,12-tetradecadienal from quaternary blends completely suppressed the male catches. The synthetic blends with this compound as a major component caught five times less males than the blends reproducing the ratio found in the female extracts [5% of (Z,E)-9,12-tetradecadienal only]. The occurrence of a minor component perceived as the most biologically relevant compound is discussed.