Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011:5:357-67.
doi: 10.2147/PPA.S22771. Epub 2011 Jul 18.

Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

Jean B Nachega  1 , Michael J Mugavero, Michele Zeier, Marco Vitória, Joel E Gallant
Affiliations

Treatment simplification in HIV-infected adults as a strategy to prevent toxicity, improve adherence, quality of life and decrease healthcare costs

Jean B Nachega et al. Patient Prefer Adherence. 2011.

Abstract

Since the advent of highly active antiretroviral therapy (HAART), the treatment of human immunodeficiency virus (HIV) infection has become more potent and better tolerated. While the current treatment regimens still have limitations, they are more effective, more convenient, and less toxic than regimens used in the early HAART era, and new agents, formulations and strategies continue to be developed. Simplification of therapy is an option for many patients currently being treated with antiretroviral therapy (ART). The main goals are to reduce pill burden, improve quality of life and enhance medication adherence, while minimizing short- and long-term toxicities, reducing the risk of virologic failure and maximizing cost-effectiveness. ART simplification strategies that are currently used or are under study include the use of once-daily regimens, less toxic drugs, fixed-dose coformulations and induction-maintenance approaches. Improved adherence and persistence have been observed with the adoption of some of these strategies. The role of regimen simplification has implications not only for individual patients, but also for health care policy. With increased interest in ART regimen simplification, it is critical to study not only implications for individual tolerability, toxicity, adherence, persistence and virologic efficacy, but also cost, scalability, and potential for dissemination and implementation, such that limited human and financial resources are optimally allocated for maximal efficiency, coverage and sustainability of global HIV/AIDS treatment.

Keywords: ART; adherence; coformulations; healthcare cost; once-daily; persistence; quality of life; simplification.

PubMed Disclaimer

Figures

None
Graphical abstract
Figure 1
Figure 1
1996 to 2011, from multiple drugs to once-daily and more potent antiretroviral therapy regimens: the long road to patient satisfaction and adherence.
See this image and copyright information in PMC

References

    1. Panel on Antiretroviral Guidelines for Adults and Adolescents . Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services; Jan 10, 2011. pp. 1–166. Available from: http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed 2011 Feb 14.
    1. McKinnon JE, Mellors JW, Swindells S. Simplification strategies to reduce antiretroviral drug exposure: progress and prospects. Antivir Ther. 2009;14(1):1–12. - PMC - PubMed
    1. World Health Organization Antiretroviral Therapy For HIV Infection Adults And Adolescents: Recommendations for a public health approach. 2010 revision. Available from: http://whqlibdoc.who.int/publications/2010/9789241599764_eng.pdf. - PubMed
    1. Henry K, Brundage R, Weller D, Akinsete O, Shet A. Comparison of generic zidovudine plus lamivudine (Cipla, Duovir) and the GlaxoSmithKline brand (Combivir) tablets. J Acquir Immune Defic Syndr. 2004;35(5):537. - PubMed
    1. Vezina H, Henry K, Ravindran GD, et al. A randomized crossover study to determine bioequivalence of generic and brand name nevirapine, zidovudine, and lamivudine in HIV-negative women in India. J Acquir Immune Defic Syndr. 2006;41(2):131–136. - PubMed