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Despite the recommendation of life-long adherence to treatment, poor compliance to dietary prescriptions is common during adolescence [3], as the risk of mental retardation due to hyperphenylalaninemia was historically thought to be insignificant at this age.
Successful therapy depends on life-long adherence to these medications.
The only existing therapy is a life-long adherence to a gluten-free (GF) diet [ 3].
The treatment of CSID consists of life-long adherence to a strict sucrose- and starch-restricted diet; however, adjuvant enzyme replacement therapy using an oral solution of yeast-derived sucrase (Sacrosidase) has been shown to be highly effective, leading to relief of symptoms and improved nutritional status [ 2, 8].
ART has other multiple limitations: (a) it requires life-long adherence preventing effective treatment from being delivered in a sustainable way to all in need; (b) it is associated with short- and long-term toxicity; (c) it does not completely restore immune integrity; and (d) it is not curative and does not eradicate HIV-1 [ 1].
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Therefore, a life-long, strict adherence to a GFD is required, and this can be difficult to achieve, particularly for adolescent and pediatric celiacs.
Adherence interventions aimed at increasing problem-solving skills have enhanced adherence to life-long treatment regimens in diabetes, HIV, and asthma [ 28- 30].
On the other hand, repeated counseling efforts to promote adherence to life-long ART was carried out at each follow-up visit, more so than in routine ART care.
The success of ART relies on life-long, high levels of medication adherence to maximize clinical effectiveness and to minimize the potential population risks associated with the development of drug resistance.
However, the remainder did feel that diabetes could be cured, or at least that adherence to a life-long regimen of control was not necessary.
The lack of association between opioid dependence and delay in HCV treatment in our study may be related to changing perceptions by French HIV physicians as they increasingly realize that opioid dependence is not a limiting condition for sustained adherence, even for life-long treatments like antiretrovirals [ 59].
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