Efavirenz/emtricitabine/tenofovir disoproxil fumarate single-tablet regimen (Atripla®): a review of its use in the management of HIV infection

Abstract

The non-nucleoside reverse transcriptase inhibitor, efavirenz, and the two nucleoside reverse transcriptase inhibitors, emtricitabine and tenofovir disoproxil fumarate (tenofovir DF) are now available as a single-tablet regimen (efavirenz/emtricitabine/tenofovir DF 600 mg/200 mg/300 mg; Atripla®). The efavirenz/emtricitabine/tenofovir DF single-tablet regimen is the first once-daily, single-tablet, triple antiretroviral therapy (ART) formulation available for the treatment of HIV infection and, in the EU, is indicated for use in adults infected with HIV-1 who have been virologically suppressed for >3 months on their current ART regimen. In treatment-experienced adults with HIV-1 infection already virologically suppressed with ART, switching to once-daily triple combination therapy with efavirenz, emtricitabine and tenofovir DF (including the single-tablet regimen) is effective in maintaining virological suppression and is generally well tolerated, according to several randomized, open-label or noncomparative multicentre trials and an open-label extension study of up to 96 weeks' duration. Moreover, additional data from some of these studies indicate that adherence to treatment was maintained or improved after switching to the once-daily triple combination, with patients generally preferring the efavirenz/emtricitabine/tenofovir DF single-tablet regimen over their previous more complex regimen and (in one of two trials) finding it easier to follow. Thus, the efavirenz/emtricitabine/tenofovir DF single-tablet regimen provides a convenient once-daily regimen for use in treatment-experienced adults that may confer an advantage over more complex or frequently administered regimens for which adherence to treatment is an issue.