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

作者：Bang**erg David R^*; Ragland Kathleen; Monk Alex; Deeks Steven G

来源：AIDS, 2010, 24(18): 2835-2840.

DOI：10.1097/QAD.0b013e328340a209

• adherence
• dosing frequency
• drug use
• homeless
• mental illness
• once daily
• one pill
• pill-burden

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.

• 出版日期2010-11-27