A single tablet regimen is associated with higher adherence and viral suppression than multiple tablet regimens in HIV plus homeless and marginally housed people

被引:138
作者
Bangsberg, David R. [1 ]
Ragland, Kathleen [2 ]
Monk, Alex [2 ]
Deeks, Steven G. [2 ]
机构
[1] Harvard Univ, Sch Med, Ragon Inst MGH MIT & Harvard, Massachusetts Gen Hosp Ctr Global Hlth, Boston, MA USA
[2] Univ Calif San Francisco, San Francisco, CA 94143 USA
基金
美国国家卫生研究院;
关键词
adherence; dosing frequency; drug use; homeless; mental illness; once daily; one pill; pill-burden; ACTIVE ANTIRETROVIRAL THERAPY; INHIBITOR THERAPY; PROTEASE; RESISTANCE; OUTCOMES; LOAD;
D O I
10.1097/QAD.0b013e328340a209
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Although, single-tablet regimen (STR) efavirenz, emtricibine, and tenofovir disoproxil fumarate (EFV/FTC/TDF) may be appealing in HIV-infected persons who are at high risk for nonadherence, the degree to which this simplified formulation affects adherence is not known. The virologic effectiveness of this STR in a potentially nonadherent population remains a concern, given the rapid selection of drug resistance seen with these drugs. Method: We performed a prospective observational study assessing adherence and virologic response to EFV/FTC/TDF STR among a cohort of homeless and marginally housed individuals. We compared adherence and viral suppression to historical controls followed in the same cohort. Results: Adherence was higher in EFV/FTC/TDF STR regimen compared to non-one-pill-once-daily therapy (P = 0.006) after controlling for multiple confounders. Viral suppression (HIV RNA <50 copies/ml) was greater in EFV/FTC/TDF STR than non-one-pill-once-daily regimens (69.2 versus 46.5%; P = 0.02), but there was no difference in viral suppression after controlling for adherence. Conclusion: Once-daily EFV/TNF/FTC STR appears to be a reasonable option for individuals with multiple barriers to adherence. Randomized clinical trials addressing various therapeutic strategies for this patient population are needed. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
引用
收藏
页码:2835 / 2840
页数:6
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