A comparison of single versus multipletablet regimens in HIV-infected people initiating antiretroviral therapy
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Universidade Federal de Minas Gerais
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Membros da banca
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Background: The once-daily single-tablet regimen
(STR) containing efavirenz, tenofovir and lamivudine
is the first choice for HIV-infected people initiating antiretroviral therapy (ART) in Brazil and few studies
have examined its influence on treatment and healthrelated characteristics compared to multiple-tablet regimen (MTR).
Objectives: To evaluate the differences of antiretroviral therapy as a STR and MTR regarding treatment and
health-related characteristics.
Methods: Baseline evaluation of a cohort of 184 HIVinfected adults (79% male, mean age 35.9) with six or
less months of ART under care in a reference hospital
in Belo Horizonte, Brazil. Recruitment occurred between Sep/2015 and Aug/2016, and data were obtained through face-to-face interviews. Quality of life
(QoL), symptoms of anxiety and depression, health
state and adherence were assessed through self-report
using validated instruments. A 40-item instrument to
be validated during the cohort was used to assess perceived barriers with ART. The regimen used was collected from the Brazilian ART delivery database
system (SICLOM). STR and MTR users were compared through non-parametric tests using Stata v.14.
Results: A slightly lower proportion of STR versus
MTR patients were non-adherent (54% vs 57%) and
had adverse effects (85% vs. 88%), anxiety symptoms
(36% vs. 41%) and depression symptoms (27% vs.
31%), though the statistical difference was not
significant (p > 0.05). The STR group showed a
higher QoL in the independence domain (p<0.01)
(WHOQoLHIV-bref) and a better self-perception of
health (p<0.05) (EQ5D VAS) than MTR group. The
MTR group had twice the odds of having difficulties
with the treatment (p<0.05). The perceived barriers
associated with MTR were “incorporate ART into work routine” (p<0.05), “swallow the pills”
(p= 0.05) and “social isolation (p<0.01)”.
Conclusions: All the characteristics analyzed in this
study tended to be better for patients using STR. Although adherence was not significantly higher in
STR group, patients reporting difficulties with treatment had twice the odds of being non-adherent. The
results indicate that single-tablet regimens may help
patients in the management of ART, reflecting in aspects of daily life activities and self-perception of
health.
Abstract
Assunto
HIV, Terapia antirretroviral, Medicamentos
Palavras-chave
HIV, Terapia antirretroviral, Medicamentos
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Endereço externo
https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275