For HIV/AIDS patients, a skipped pill could mean the difference between health and hazard for the entire population. A breath monitoring device developed by scientists at the University of Florida and Xhale Inc. could help prevent the emergence of drug-resistant strains of HIV, by monitoring medication adherence in high-risk individuals.

The researchers developed the adherence monitor by incorporating minute amounts of an alcohol into a gel capsule. The additive, called 2-butanol, is one of many GRAS - Generally Recognized as Safe - compounds approved by the Food and Drug Administration for use in foods. The monitor records the results of each breath test, allowing patients to bring a memory card or USB key to the clinic once a month and receive a printout of their results.

"For HIV, it's been shown that if you don't take a very high percentage of your medication, you may as well not take medication at all," said Dr. Richard Melker, a professor of anesthesiology at the University of Florida College of Medicine and chief technology officer for Xhale. While experts have tried many methods to monitor drug adherence, ranging from daily log books to blister packs that record the time each pill is dispensed, Melker asserts that only directly observed therapy, or DOT, works well. "If we had a good way of doing DOT that's realistic, instead of having someone come to your house or you going to clinic every day of your life, then we would know whether these people stopped taking their medication and why," Melker said.

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