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

David Bangsberg, Kathleen Ragland, Alex Monk, Steven G. Deeks

Research output: Contribution to journalArticle

131 Citations (Scopus)

Abstract

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-onepill- 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-onepill- 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.

Original languageEnglish (US)
Pages (from-to)2835-2840
Number of pages6
JournalAIDS
Volume24
Issue number18
DOIs
StatePublished - Nov 27 2010
Externally publishedYes

Fingerprint

Tablets
HIV
Tenofovir
efavirenz
Drug Resistance
Population
Observational Studies
Randomized Controlled Trials
Prospective Studies
RNA
Therapeutics
Pharmaceutical Preparations

Keywords

  • Adherence
  • Dosing frequency
  • Drug use
  • Homeless
  • Mental illness
  • Once daily
  • One pill
  • Pill-burden

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

A single tablet regimen is associated with higher adherence and viral suppression than multiple tablet regimens in HIV+ homeless and marginally housed people. / Bangsberg, David; Ragland, Kathleen; Monk, Alex; Deeks, Steven G.

In: AIDS, Vol. 24, No. 18, 27.11.2010, p. 2835-2840.

Research output: Contribution to journalArticle

@article{4570d4ea88a0413aadff18a9cf499986,
title = "A single tablet regimen is associated with higher adherence and viral suppression than multiple tablet regimens in HIV+ homeless and marginally housed people",
abstract = "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-onepill- 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-onepill- 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.",
keywords = "Adherence, Dosing frequency, Drug use, Homeless, Mental illness, Once daily, One pill, Pill-burden",
author = "David Bangsberg and Kathleen Ragland and Alex Monk and Deeks, {Steven G.}",
year = "2010",
month = "11",
day = "27",
doi = "10.1097/QAD.0b013e328340a209",
language = "English (US)",
volume = "24",
pages = "2835--2840",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "18",

}

TY - JOUR

T1 - A single tablet regimen is associated with higher adherence and viral suppression than multiple tablet regimens in HIV+ homeless and marginally housed people

AU - Bangsberg, David

AU - Ragland, Kathleen

AU - Monk, Alex

AU - Deeks, Steven G.

PY - 2010/11/27

Y1 - 2010/11/27

N2 - 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-onepill- 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-onepill- 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.

AB - 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-onepill- 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-onepill- 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.

KW - Adherence

KW - Dosing frequency

KW - Drug use

KW - Homeless

KW - Mental illness

KW - Once daily

KW - One pill

KW - Pill-burden

UR - http://www.scopus.com/inward/record.url?scp=78549267434&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78549267434&partnerID=8YFLogxK

U2 - 10.1097/QAD.0b013e328340a209

DO - 10.1097/QAD.0b013e328340a209

M3 - Article

VL - 24

SP - 2835

EP - 2840

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 18

ER -